Top 10 Changes Affordable Care Act (aka "Obamacare" 2010 ) already in place

Discussion in 'Non Sun City Related Discussions' started by suncityjack, Jul 19, 2013.

  1. suncityjack

    suncityjack Active Member

    The Top 10 health care changes already in place:

    1. Goodbye doughnut hole. Medicare drug plans (Part D of Medicare) stop providing insurance to people after their claims for covered drugs hit a certain level ($2,970 in 2013), and coverage doesn't resume until spending hits another level ($4,750 in 2013). Health care reform is closing this doughnut hole in annual stages, and it will be totally closed by 2020. Savings to Medicare beneficiaries will be in the tens of billions of dollars.

    2. Free Medicare preventive services. Health care reform greatly expanded the menu of free preventive services to Medicare consumers.

    3. Free preventive services to all women. Health insurance plans have added eight women's health benefits because of the law, in areas including breastfeeding, contraception, domestic violence, gestational diabetes, HIV screening and counseling, sexual diseases and wellness visits. These benefits are free, meaning they involve no co-payment or co-insurance, and women don't need to meet their plan deductibles to use these free services.

    4. Pre-existing conditions. Beginning in 2014, no one can be denied health insurance because of a pre-existing medical condition.

    5. Premium equity. Insurers can't gouge people with pre-existing conditions by forcing them to pay unreasonably high premiums. The law also limits insurers' ability to impose age-related premium increases for private coverage.

    6. End of pre-existing restrictions on children's access to health insurance. The law has ended insurance denials based on pre-existing conditions for the roughly 20 million children under age 19.

    7. Adult dependent insurance coverage. Adult children up to age 26 can now continue to get health insurance on their parent's policies.

    8. Insurance payout limits. The law will end lifetime limits on insurance payouts. It also has been phasing out annual coverage limits, and these will be completely outlawed for insurance plans taking effect next year.

    9. Minimum medical loss ratio for insurers. Health insurers must spend at least 85 percent of their premium dollars on health care (80 percent for smaller group plans) or rebate shortfalls to consumers.

    10. New consumer health coverage reports. Consumers have begun receiving a standardized report explaining their health insurance. This seemingly modest accomplishment is actually a big deal. For the first time, different health insurance plans have to present their coverage details in the same format, using the same language. Consumers can now accurately compare different health insurance plans.
     
  2. Cynthia

    Cynthia Well-Known Member

    That's a helpful summation. I didn't know about the end of lifetime payouts.
     
  3. pegmih

    pegmih Well-Known Member

    I have recently heard of 3 people who have received a letter from their doctor that he/she is no longer available.
    These people now have to find a new doctor.
     
  4. Anita Mae

    Anita Mae New Member

    Appreciate your updated info -- SCJACK !!! I also read similar in my AARP info.
    I already benefited from my wellness checks -- thought that was nice !:distant:
     
  5. gilmark

    gilmark New Member

    I am hopeful my husband can get a reasonable Plan B now because of the pre-existing illness clause being scrapped.
     
  6. Anita Mae

    Anita Mae New Member

    time will tell

    Time will tell...hopefully all those you had a pre-existing type illness will get some help with this.
     
  7. suncityjack

    suncityjack Active Member

    I think the program can have even greater potential, but for maximum benefits for all, the pool needs to be the largest possible and that includes getting the younger folks who believe they are invincible aboard. Getting their baseline stats recorded and getting them into the wellness habit will save a lot for them and society down the road. Playing Russian roulette with healthcare is far too dangerous since instead of only one bullet in the chamber, chances are most of us have a lot more....
     
  8. archer

    archer New Member

    The ACA will only be successful if the citizens get behind it....and right now there is so much misinformation out there that I wonder if anyone really knows what it contains. Some people have already gotten their rates under the ACA for next year....I know some have gone up, but my son, who has a graphic design business in NYC, found his rate and those of his employees going down almost 30%. I wish it had been around before I went on Medicare.....I was self employed, paid my own health insurance, and as the rate sky rocketed I couldn't change plans because of a pre-existing condition.
     
  9. suncityjack

    suncityjack Active Member

    Too late for you but at least not your son. That's some savings. I was hit most when between jobs and then couldn't afford the outlandish COBRA rates, so hope they can smooth out that snag for people too.
     
  10. Cynthia

    Cynthia Well-Known Member

    I hope the Republicans don't hold the government hostage because of this. They say they will not pass the budget if Obama care is included, which I don't understand since even the Supreme Court ruled in it's favor. It will not be perfect at the start but how can it be improved if we don't give it a try?
     
  11. Cynthia

    Cynthia Well-Known Member

    They try to say that many doctors will not accept Medicare now. Every doctor I work with around here does, even the ones who do not take private insurance. They take Medicare because it pays and pays faster, even if the rates might be lower. Do any of you have problems finding an MD who takes Medicare?
     
  12. archer

    archer New Member

    I have only once been told that a particular doctor doesn't take medicare, that was here in Colorado. In AZ, any doctor I have wanted to see has taken medicare. When it came to an orthopedic doc for my rotator cuff surgery, I went to the same office the Bronco's use, and yep....he took medicare.
     
  13. suncityjack

    suncityjack Active Member

    New medical bldg opened up by T-bird and 99th and their ad touted accepting Medicare patients. BTW, it's a lovely new bldg that has some great aerial shots of Sun City under construction--worth a look. The local historical society is listed as the "courtesy of" so that's nice.
     
  14. suncityjack

    suncityjack Active Member

    Looks like some upcoming informative sessions re: Obamacare/Affordable Care Act being put on by The Area Agency on Aging. The ad said it will tell about how the act will change Medicare, Medicaid, and private healthcare coverage options for the general population. Premium sudsidies and tax penalties connected with the individual mandate and the impact on employers. The presenter is Glen Spencer, a benefits assistance program director and he was a medical case manager representing clients filing for Social Security disability and assisting with Medicare enrollments.
    The first mtg takes place on Sept. 10 at 10 a.m. at the Sun City Elks Lodge, 10760 W. Union Hills Drive. Call 623 972-9552 Refreshments will be served.
    Same man and presentation at SC. Branch Library and it says registration is needed. It's 1-2 p.m. on Sept. 19.
    Might really help clear up all the misinformation you may have been getting by email. Seems every time it comes and I check it on Snopes or the other fact checkers, it's info laden with misinfo.
     
  15. Fiona

    Fiona New Member

    Great information!
     

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