More Misinformation About Medicare and the Affordable Care Act

AffordableCareAct-Medicare-TruthThe other day we were on a discussion regarding the Affordable Care Act (referred by many as ObamaCare) and a link was posted to a site showing you 50 things to be afraid of about the Affordable Care Act. Some of the people who were engaged in the conversation, truly believe the 50 points.

That conversation initiated my blog yesterday Medicare and the Affordable Care Act – Truth or Lies and I guess I am on a campaign to let as many people as I can know about some of the lies and misleading statements that have been made about the Affordable Care Act, in particular those people on Medicare or approaching Medicare eligibility.

I followed the link and started to read the points and compare the sections to the actual law which is H. R. 3590 and I couldn’t find paragraphs or pages that agreed or matched up.

I decided it was best to start reading the website page and discovered they were referring to HR 3200 (which never made it past Nancy Pelosi’s desk) and proceeded to say that the points are what you could “expect” from the law and that their list was only a guide. In other words, they couldn’t substantiate their claims.

One of the fears that has been presented and gone viral is the statement below and according to FactCheck.org has been shown to be a misleading statement: http://www.factcheck.org/2009/08/twenty-six-lies-about-hr-3200/  This for me is truly bothersome because people actually believe it without investigating the truth and many on Medicare fear the worst regarding the future of their healthcare.

Claim: Page 335: Government mandates establishment of outcome-based measures: i.e., rationing.

Misleading. This section does deal with establishing quality measures for Medicare. It does not make any recommendations for treatment, or empower anyone to make treatment recommendations based on those measures. The only effect of these outcome-based measures established in the bill would be ranking and potential disqualification of under performing Medicare Advantage plans – that’s disqualification of the plans, not of any medical procedures.

It is unfortunate that many people who are enrolled in Medicare or approaching eligibility actually believe these statements. This site has done a CYA to say it is only a guide, but has successfully put fear into people. How cruel can you be?

If you want to visit the site, here’s the link: coachisright.com/special-reports/50-dangers-from-obamacare/ You’ll need to copy/paste into your browser as I don’t believe it deserves a hyperlink.

If you have heard of something about Medicare and the Affordable Care Act let’s do some research and let others know the truth.

Medicare and the Affordable Care Act Truth or Lies

medicare-truth-or-lies

Part of the Affordable Care Act establishes an Independent Medicare Advisory Board. Some people are saying that this board will start to ration healthcare. As a matter of fact I heard a story on how a women was denied a heart valve procedure because she had “aged out” and the procedure could not be performed on someone over the age of 75. This really concerned me.

I said to myself, Medicare is “rationing” or “aging out” beneficiaries. This just couldn’t be true. And, guess what … it wasn’t.

Turns out this woman was not in the Medicare program and has private insurance. It is the private insurance carrier’s policy not to allow this procedure for anyone who is over the age of 75 and insured by them, not Medicare.

I just couldn’t believe Medicare would be doing this. I had to go and find out what all this chatter was regarding the “rationing” of healthcare.

And, as I suspected it’s the “twist & spin” of the media, advocacy groups, talks shows, radio and TV, that contribute in some way to  misinformation and to the truth.

Just to clear a few things up, the Independent Medicare Advisory Board cannot ration health care:

‘‘(ii) The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary  premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost-sharing (including deductibles, coinsurance, and copayments), or otherwise restrict benefits or modify eligibility criteria.

If you want to do some further reading you can visit AARP as they have quite a few fact sheets about this. Visit  http://www.aarp.org/health/health-care-reform/health_reform_factsheets/

I don’t think we can ever stop the “twist & spin” of advocacy groups, talk shows, etc., but if it isn’t making sense do some further reading or research to find out the truth and let’s try and stop these rumors.

Medicare While Working

Medicare Tips for Seniors is pleased to have another guest post by Ross Blair, CEO of PlanPrescriber

medicare-workingAs more people work past age 65, the eligibility age for Medicare, more people will need to navigate an increasingly complex web of employer and Medicare coverage. The decisions they make today could have costly, long-term implications.

A recent survey of caregivers conducted by eHealth, the parent company of PlanPrescriber.com, found that 80 percent of baby boomers expect to be working after their 65th birthday. Many will have health insurance through their employer. But this group must also consider how Medicare impacts their coverage and their choices. The same survey found that many baby boomers do not understand basic parts of how the Medicare program actually works. Certain parts of Medicare coverage are only guaranteed when you first become eligible for the program – even if you are working. Read the rest of this entry

Original Medicare: National Program for Diabetes Supplies for 2013

Happy New Year!

diabetic-testing-supplies-medicareWe recently received a notification from CMS (Centers for Medicare & Medicaid Services) announcing a national Medicare mail order program in 2013 for diabetic supplies.

If you are in Original Medicare and get your diabetes testing supplies delivered to your home, there are changes coming and depending upon your area some mail order suppliers’ contracts have ended on December 31, 2012.

What’s happening? Medicare is setting up a national mail-order program and it is scheduled to start in July 2013.

In the meantime, you need to check with your supplier to make sure they are still in the program and their contract has not ended.

If your 2012 supplier is no longer in the program, you can go to the local pharmacies, like Wal-Mart, CVS, Walgreens to get your supplies until the national program takes effect.

If you are in a Medicare Advantage Plan, make sure you check with your plan to find out who you should be getting your diabetic supplies from.

Will keep you posted as new information is published.

Balance is Key in Preventing Falls

Medicare improving-balanceOpen Enrollment is closed for 2013. But it will be back on October 15, 2013 for the 2014 Open Enrollment Period.

Since there isn’t too much to write about at this time about Medicare, I have a little off subject post. I subscribe to Harvard Medical School’s Health Publications. The publications are not free, they actually cost $18.00+ depending upon how you want to receive the publication.

I purchased one because the title caught my eye, “Better Balance – Easy exercises to improve stability and prevent falls”.  We have all seen the TV ad for life alert device  “Help I’ve fallen…” Read the rest of this entry

Medicare Open Enrollment Ends December 7, 2012

Just a reminder, Medicare Open Enrollment for 2013 ends on December 7, 2012.

Visit http://medicare.gov to review the new plans for 2013. Or, if you are satisfied with your current plan, do nothing and you will be automatically enrolled in either your Medicare Advantage Plan or Medicare Part D Prescription Drug Plan.

Let us know if you have any questions about open enrollment.

Have a great Holiday Season!

It’s Flu Season and Medicare Pays for Flu Shots

Did you get your flu shot yet? Medicare does cover certain vaccines and immunizations.

Medicare Part B covers the following vaccines:

  • Influenza (the flu) (Currently, the seasonal flu shot includes both a seasonal flu shot and an H1N1 (swine flu) vaccination.)
  • Pneumonia
  • Hepatitis B (if you are at medium to high risk).

These vaccines have had no co-payment since 2011.

Now if you happen to step on a rusty nail or get cut by some object Medicare will pay for a Tetanus shot. But won’t pay for the shot unless you have had an injury, virus or dangerous disease. Read the rest of this entry

Which Medicare Plan Is Right For You?

One of the things I do every year is investigate what the Medicare Advantage plans are offering. So I just did that for 2013.

Over the last several years, Part D (Prescription Drug Plan) providers have been eliminating offering a $0 deductible. There are very few providers who offer the $0 deductible in the stand alone Medicare Part D Prescription drug program. We know that Medicare Part D has an annual deductible of $320 for 2012 and in 2013 it will go up by $5 to $325.

As I started my review of Medicare Advantage plans in my area, there were 35 plans that offered prescription drug coverage. And let me tell you how surprised I was. Not one of the plans had the annual deductible for Part D. They were all $0 deductible if you joined their plan.

I noticed for 2013 the out-of-pocket expenses seem to have dropped slightly. Read the rest of this entry

Medicare 2013 Open Enrollment: Ask Yourself A Few Questions

On October 1, 2012 the Medicare Open Enrollment marketing for 2013 began!

I’m sure you are receiving all types of marketing material in the mail, the newspapers have many advertisements, and of course the TV and radio ads.

Remember, you can change your plans starting October 15th until December 7th.

Whether you have Original Medicare, Medicare Advantage, or Medicare Part D, think about this:

  • Is there anything major with your health that has changed during the year?
  • Is there anything different about your financial status that has changed?
  • Are you taking different medications?

Now think about the Medicare plans you are currently enrolled in and ask yourself:

  • Has anything in my current plan changed for 2013?
  • Is my doctor still in the plan?
  • Have the premiums increased?
  • Have co-payments increased?
  • Does my plan still cover all my medications?
  • Is my local pharmacy still a “preferred” pharmacy? Read the rest of this entry

2013 Premium for Medicare Part D: Excessive Increase


I received an email the other day from Q1Medicare (very informative site) and they have been obtaining some of the premiums listed with Medicare for 2013.

I fully expected an increase for 2013 when we signed up for First Health’s Part D plan in 2012 (Coventry Health). At that time, the premium was “too good to be true” for an insurance company. It was always in the back of my mind they will probably hand out an increase for 2013. A few years back, they had increases in excess of 40% for both the premium and the co-payment.

This year, in Florida, they are giving us a 31% increase. Is that increase really necessary? Or is this just “greed” by the Insurance Company? Read the rest of this entry

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