Saturday, September 01, 2012
THE TRUTH ABOUT HEALTH CARE
You do not have to be a member to take advantage of AARP's expertise about heath care. They have published many docs explaining the Affordable Health Care Act and how it affects or does not affect virtually every American.
Here is what I found out.
First, for current seniors, Medicare benefits are the same. Second, you can keep your current doctor if you wish. Third, many preventive screenings, like colonoscopies and mammograms are FREE. Fourth, prescription drugs costs will be gradually reduced as the gap known as the "doughnut hole" of Part D is closed by 2020.
Taken together, the cumulative measures of the law will SAVE the average Medicare beneficiary $4,181 over 10 years, those with high drug costs even more, up to $16,000.
There will be more FOLLOW UP CARE post hospitalization. Hospitals will be monitored for excessive re-admissions which indicate incompetence or "churning" for profits. Post op follow ups with home nursing care will be increased. (This is the provision that stirred the scare talk about "death panels" that decide to kill your grannie.)
The costly Medicare Advantage plan will be more costly and doctors and hospitals will have adjustments to their payments under that plan. Higher income beneficiaries will continue to have higher premiums.
EMPLOYER COVERAGE PLANS stay the same. But consumers will have a choice to go to a different plan provided through an EXCHANGE set up in each state where companies will compete for participants, reducing costs.
Low and middle income ($44, 680) people can receive SUBSIDIES as refundable tax credits to join an exchange.
For people not covered by medicare, medicaid or other insurance plan, Failure to buy insurance by Jan. 1, 2014 means a tax imposed on tax return. EXEMPT are people with low income. The penalty in 2014 is $95 or 1% of income. It will increase over time, affecting tax refunds BUT NOT A CRIME.
MEDICAID which is for low income people will depend on the states which defines eligibility rules. The intent was to add 16 million to the rolls but the Supreme Court ruled that states may opt out and at least 12 Republican governors have refused to join.
State health insurance exchanges set up to provide cheaper plans plus refundable tax credits will help some low and middle income people get covered.
If a state fails to set up an EXCHANGE the federal government may do so.
Insurance companies will no longer be permitted to deny coverage or charge more or reduce benefits for people with PRE-EXISTING CONDITIONS. This will affect an estimated 129 million people. They cannot any longer charge women with higher premiums than men. Premiums charged by Insurance companies will be closely monitored and rebates will be required for excessive charges.
High income people ($200,000 for one or $250,000for couple) will pay higher Medicare hospital insurance on income and earnings.