the health care law: what it means for people with medicare
TRANSCRIPT
The Health Care Law: What it Means for
People with Medicare
WelcomeWelcome
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Agenda
What’s changing
What’s not changing
When changes take place
Q & A
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How The Law Improves Medicare
Protects guaranteed Medicare benefits Improves Medicare benefits
• Lowers prescription drug costs
• Adds more preventive benefits
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What’s The Doughnut Hole?
Medicare Part D coverage gap
• Fall into the doughnut hole after totaldrug costs reach $2,970• Leave the doughnut hole when total out-of-pocket drug costs reach $4,750
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Medicare Drug Coverage
Discount:52.5% for
Brand
21% for Generic
Initial Benefit Catastrophic Benefit
You pay: Deductible and 25% of drug costs
You pay: 5% of drug costs
Doughnut Hole
Doughnut Hole Disappears
52.5% discount on brand name drugs
21% discount on generic drugs
By 2020, the doughnut hole will disappear
Part D cost sharing will remain
AARP’s Doughnut Hole Calculatorwww.aarp.org/doughnuthole
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www.aarp.org/doughnutholewww.aarp.org/doughnuthole
Adds More Preventive Care Benefits
Yearly wellness visit
Screenings for diabetes and cancers
No co-payments or deductibles
Call Medicare at 1-800-633-4227www.medicare.gov
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Improves Access To Primary Care Doctors
Primary care doctors get bonus payments
Medicare gives extra payments where shortage of providers
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Improves Care CoordinationMust have a face-to-face visit from a health
practitionerA physician must certify home health
servicesVisit must occur within• 90 days before you receive home health care
or • 30 days after you start care
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Medicare Advantage Plans
Alternative to Original MedicareOffered by Medicare-approved private
insurance companiesPays for the same basic health care
services as Original MedicareMay also pay for additional services
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Changes To Medicare Advantage Plans
Guaranteed Medicare benefits are protected
Choose either a Medicare Advantage plan or Original Medicare
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More Emphasis On Quality & ValueBonuses for providing quality careUse some of the bonus for extra benefits and
rebatesCan’t charge more than Original Medicare for
certain services Must limit how much they spend each year
on administrative expenses
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How Medicare Advantage Plans Are Paid
Subsidies to private insurance companies will be lower
Changes in payments will result in savings to the Medicare program
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What Lower Subsidies Could MeanMay drop extra services May raise premiums and co-paymentsMay leave the Medicare program
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What Lower Subsidies Could Mean
You will receive a notice of changes, if any
You can stay with your plan, switch your plan, or go to Original Medicare
Contact your Medicare Advantage plan or call Medicare at 1-800-633-4227
www.medicare.gov
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Part D Income-Related Premiums Income levels for higher premiums start
$85,000 -- single person $170,000 -- married couple
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Reduces Waste, Fraud & Abuse
Cuts inefficient care
Identifies fraudulent providers
Reduces overpayments to insurance companies
Protects personal information
Call Medicare at 1-800-633-4227www.aarp.org/fightfraud
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Remember!
Helps lower prescription drug costs
Protects guaranteed Medicare benefits
Improves Medicare-covered benefits
Makes some changes to Medicare Advantage plans
Reduces waste, fraud and inefficiencies
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For More Information
The Health Care Law HealthLawAnswers.org MiLeydeSalud.org
Medicare www.Medicare.gov 1-800-633-4227
SHIP www.SHIPtalk.org 1-800-677-1116
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www.aarp.org/ShareYourThoughtswww.aarp.org/ShareYourThoughts
Has the Health Care Law helped you?Has the Health Care Law helped you?
Share your personal story
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Upcoming Web EventsUpcoming Web Events
www.aarp.org/HealthWebinarswww.aarp.org/HealthWebinars