Obamacare and Medicare

Mac McLean / The Bulletin Published Nov 1, 2013 at 05:00AM

Editor’s Note: Good Question is a recurring feature in which a local expert in a particular field answers a question related to families and aging. Have a question? Send it to mmclean@bendbulletin.com.

Q: How will the Affordable Care Act, which launched its first online health insurance marketplaces earlier this month, affect my Medicare benefits?

A: Stephanie Magill is the regional spokesperson for the Center for Medicare and Medicaid Services’ Region 10 office in Seattle. This office serves as the main point of contact for any resident of Alaska, Idaho, Oregon or Washington who has an issue with Medicare coverage.

Commonly known as Obamacare, the Affordable Care Act set up a series of online marketplaces, such as Cover Oregon, earlier this month that give people who do not have health insurance a place to shop for an affordable plan.

It is a completely different program than Medicare — which provides health insurance benefits to people who are 65 or older or meet certain other conditions — even though both programs have open enrollment periods that overlap (see “Sign up for Coverage” on Page D2).

But this separation doesn’t mean the two programs do not interact, Magill said.

“The Affordable Care Act has changed the Medicare program for the better,” Magill said, listing ways Medicare has changed since the Affordable Care Act became law in 2010. Many of these changes have already occurred, she said.

Magill said one of the biggest changes the Affordable Care Act brought to the Medicare program is that it increased the number and type of preventive health care screenings people who have Medicare Part B coverage can get for free. These tests include a bone mass measurement, cholesterol screenings, diabetes screenings, flu shots, mammograms and tests for cervical, colorectal and prostate cancers.

She said Medicare also gives its beneficiaries one free wellness visit each year after they have the “Welcome to Medicare” doctor’s appointment that comes when they first sign up for their coverage. It extended the amount of time beneficiaries are eligible to receive this free introductory visit from six months after they enroll to a year, provided them with access to free health and nutrition classes if they have diabetes and gave them the ability to get free tobacco cessation counseling if they do not already suffer from a smoking-related ailment.

Because of the Affordable Care Act, she said, the Medicare program has also capped the amount of out-of-pocket costs a person who has a Medicare Advantage plan can incur and started a process that will eliminate the “doughnut hole” some beneficiaries encounter with their prescription drug coverage by 2020.

Signing up for coverage

Cover Oregon, a health insurance marketplace set up by the Affordable Care Act, and Medicare are both having their open enrollment periods this month. Here is what you need to know if you want to sign up for the health insurance benefits that best fit your needs:

Cover Oregon

• Provides a place where people who do not have health insurance or are not yet eligible for Medicare can find an insurance plan

• Open enrollment for Cover Oregon started Oct. 1 and runs until March 31.

• For more information, visit www.coveroregon.com or call 855-268-3767.

Medicare

• Provides health insurance benefits to people who are 65 or older, have received Social Security disability benefits for two years or who have end-stage renal disease. Basic Medicare is free for most people, but there is a charge for expanded services such as Medicare Part B and prescription drug coverage.

• Open enrollment for Medicare started Oct. 15 and runs until Dec. 7.

• For more information, visit www.medicare.gov or call the federal Medicare program at 1-800-MEDICARE if you need general Medicare information or the program’s Region 10 office at 206-615-2354 if you have a specific question.