Clarifying the Affordable Care Act For Senior Citizens

By Toni Lynn Davis, MHA, CNHA, FACHCA

CEO and President Green Hill Inc.

“About 17% of seniors incorrectly believe the Affordable Care Act replaces their Medicare with insurance policies purchased on line through the state and federal health insurance exchanges according to a study released exclusively to USA TODAY.

The Affordable Care Act (ACA) is legislation that seniors need to understand so they don’t make any unnecessary changes to their healthcare out of ignorance, fear, or as a result of unscrupulous individuals looking to take advantage of the confusion.

The ACA was enacted to enable and require those persons that do not have health insurance, and who are not provided health insurance by their employers, to enroll in a health insurance plan.  No one may be turned away for preexisting conditions. All uninsured persons will have to pay a yearly fine if they do not purchase health insurance. This enrollment of the uninsured is believed to reduce the overall cost of health care for the majority of citizens.

For those who do not have healthcare insurance the initial phase begins Oct 1st and runs through March 2014. An uninsured citizen or legal resident may select a health insurer from a list of state or federally assigned providers. New Jersey elected not to participate in setting up its own health insurance co-op so New Jersey residents will choose from the Federal list of providers on a web site exchange on www.healthcare.gov. Rates do vary by region of the country for similar services and one may choose moderate to high levels of coverage. The law provides tax credits based on income levels.

For our seniors if you already have health insurance provided by Medicare you do not need to do anything. You are already covered and your benefits will not change whether you are enrolled in traditional Medicare or Medicare Advantage Plan. Seniors without healthcare coverage should still enroll in Medicare directly through www.medicare.gov.

The Affordable Healthcare Act does expand the eligibility for Medicaid which remains accessible through www.medicaid.gov. “New Jersey has about 1.2 million people enrolled in Medicaid. According to the Urban Institute, and additional 307,000 will be eligible because of the law’s expansion of the Medicaid program.” Star Ledger Guide to Obamacare.  

For most people, seniors included, prescription drug costs in the ‘doughnut hole’ coverage gap will not increase but is legislated through the ‘Act’ to decrease. “The law closes the infamous Medicare Part D prescription drug "doughnut hole," in which Medicare beneficiaries paid full price for prescription drugs after exceeding a certain dollar limit each year. Now enrollees who reach the doughnut hole get large discounts, and by 2020, the hole will close.” AARP 11 Myths about Healthcare Reform.

If you have private health insurance or insurance provided by an employer and you would like to see if you can get similar coverage for lower rates you may consider exploring joining an Affordable Care Act plan. 

It is important that senior citizens are aware of the facts of the Affordable Healthcare Act. There will be many ‘scammers’ out there who will try to take advantage of the confusion and misinformation around this new legislation. If you are a senior citizen with Medicaid or Medicare coverage, or a private or employer funded health insurance plan you need to take no action at this time to be in compliance with the Affordable Healthcare Act. For more information about the Affordable Healthcare Act or to enroll visit www.healthcare.gov.

Sources and additional information on this subject can be found at www.greenhillpressroom.com