Medicare is NOT the Affordable Care Act … ACA is For People Under 65

medicare-workingIt is totally mind-boggling how many different blogs, statements, videos become viral about the Affordable Care Act and Seniors on Medicare. So when I hear statements that to me just don’t make sense, I really need to investigate and sort out fact from fiction.

One recent example was that the Affordable Care Act stated you could only receive palliative care only after age 76. I just shook my head in total disbelief, and still can’t understand why people believe these incorrect messages being sent.  But yet, it continues to go round-and-round. If people really took the time and realized the Affordable Care Act (ACA) is for people under the age of 65 and if you are 76, you are on Medicare!

So if you hear or read someone say you can’t get Palliative care until you are 76 under the Affordable Care Act, remind them that ACA is for people under age 65 and when you are 76 you are on Medicare.

Let’s remember that at age 65 you are eligible to enroll in Medicare and Medicare has been established since 1964 when President Lyndon B. Johnson signed it into law.

Does Medicare cover Hospice and/or Palliative care? Here’s what Medicare has to say:

Hospice & Respite Care

Who’s eligible?

People with Medicare who meet all of these conditions are covered:

  • You’re eligible for Medicare Part A (Hospital Insurance).
  • Your doctor certifies that you’re terminally ill and are expected to have 6 months or less to live.
  • You accept palliative care (for comfort) instead of care to cure your illness.
  • You sign a statement choosing hospice care instead of routine Medicare-covered benefits for your terminal illness.

Hospice care is usually given in your home and includes these services when your doctor includes them in the plan of care for palliative care (for comfort) for your terminal illness and related condition(s):

  • Doctor services
  • Nursing care
  • Medical equipment (like wheelchairs or walkers)
  • Medical supplies (like bandages and catheters)
  • Drugs for symptom control or pain relief (may need to pay a small co-payment)
  • Hospice aide and homemaker services
  • Physical and occupational therapy
  • Speech-language pathology services
  • Social work services
  • Dietary counseling
  • Grief and loss counseling for you and your family
  • Short-term inpatient care (for pain and symptom management)
  • Short term respite care (may need to pay a small co-payment)
  • Any other Medicare-covered services needed to manage your pain and other symptoms related to your terminal illness, as recommended by your hospice team

When YOU choose hospice care, you’ve decided that you no longer want care to cure your terminal illness and/or your doctor has determined that efforts to cure your illness aren’t working.

Does this sound like you have to wait until you are 76?

As you read through Medicare, you will see that there is nothing that states you have to be 76 years of age in order to receive Hospice or Palliative care.

Did you know that Medicare is the most popular program in this country?

Posted on 10/05/2013, in Medicare General and tagged , , , . Bookmark the permalink. Leave a comment.

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