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Senior center hcr


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Senior center hcr

  1. 1. Patient Protection and Affordable Care Act of 2010 Sarah M Taylor Sedgwick County Extension FCS SHICK Coordinator
  2. 2. How many of you. . . <ul><li>Have heard about the Health Care Act? </li></ul><ul><li>Have fears about your Medicare? </li></ul><ul><li>Want to know the truth about Health Care reform? </li></ul>
  3. 3. What have you heard. . . <ul><li>Rumors </li></ul><ul><ul><li>Medicare is ruined, it will never be the same </li></ul></ul><ul><ul><li>I will lose my benefits </li></ul></ul><ul><ul><li>I will not be able to choose my doctor </li></ul></ul><ul><li>Hopefully we will put those fears to rest today. </li></ul>
  4. 4. Medicare Stays the Same <ul><li>The guaranteed Medicare benefits you currently receive will remain the SAME! </li></ul><ul><li>Will continue to have the choice between Original Medicare & Medicare Advantage Plan </li></ul><ul><li>Medicare will continue to cover your health costs the way it always has, and there are no changes in eligibility </li></ul>
  5. 5. Medicare Part D <ul><li>2010 </li></ul><ul><ul><li>Anyone who reaches the coverage gap in 2010 will receive a $250 rebate from the Centers for Medicare and Medicaid Services (CMS) </li></ul></ul><ul><ul><li>Checks will begin mailing in mid June and will be mailed monthly through the rest of the year as beneficiaries enter the coverage gap (first it was thought that checks would only be mailed quarterly) </li></ul></ul>
  6. 6. March 15, 2011 February 17, 2011 December 31, 2010 February 17, 2011 January 13, 2011 November 30, 2010 January 13, 2011 December 15, 2010 October 31, 2010 December 15, 2010 November 11, 2010 September 30, 2010 November 11, 2010 October 22, 2010 September 15, 2010 October 22, 2010 September 21, 2010 July 31, 2010 September 21, 2010 August 19, 2010 June 30, 2010 August 19, 2010 July 15, 2010 April 30, 2010 July 15, 2010 June 10, 2010 February 28, 2010 If No Check By This Date, Call Plan then 1-800-MEDICARE Beneficiary Can Expect The Check to be Mailed By Beneficiary Reaches the Coverage Gap By
  7. 7. Medicare Part D <ul><li>2011 </li></ul><ul><ul><li>Name brand Part D covered drugs will be discounted 50% in the coverage gap </li></ul></ul><ul><ul><li>The 50% discount comes for the drug manufacturer </li></ul></ul><ul><ul><li>The full cost of the drug will count towards the out-pocket-costs </li></ul></ul><ul><ul><li>Annual Election Period will be October 15 to December 7 </li></ul></ul>
  8. 8. Preventative Services <ul><li>Medicare Covers. . . </li></ul><ul><ul><li>Mammograms </li></ul></ul><ul><ul><li>Colon Cancer Screenings </li></ul></ul><ul><ul><li>Cervical Cancer Screenings </li></ul></ul><ul><ul><li>Heart Disease Screenings </li></ul></ul><ul><ul><li>Diabetes Screenings </li></ul></ul><ul><ul><li>Prostate Cancer Screenings </li></ul></ul><ul><ul><li>Flu, Pneumonia, Hepitis B Shots </li></ul></ul>
  9. 9. Original Medicare Preventative Services <ul><li>2011 </li></ul><ul><ul><li>All preventative Services will be FREE to those on Original Medicare! </li></ul></ul><ul><ul><li>This will affect those with only Original Medicare and no supplement. </li></ul></ul><ul><ul><li>Those with a Medicare Advantage plan may still have some co-pay amounts to pay on those preventative services </li></ul></ul>
  10. 10. Annual Wellness Exam <ul><li>Starting January 1, 2011 </li></ul><ul><ul><li>ALL Medicare beneficiaries will be able to receive an annual wellness exam for FREE! </li></ul></ul><ul><ul><li>Medicare has NEVER covered an annual wellness exam. </li></ul></ul>
  11. 11. <ul><li>Personal risk assessment & prevention plan services includes: </li></ul><ul><ul><li>Exam for </li></ul></ul><ul><ul><ul><li>Height </li></ul></ul></ul><ul><ul><ul><li>Weight </li></ul></ul></ul><ul><ul><ul><li>Body mass index </li></ul></ul></ul><ul><ul><ul><li>Blood pressure </li></ul></ul></ul><ul><ul><ul><li>Other routine measurements </li></ul></ul></ul><ul><ul><li>Detection of cognitive impairment </li></ul></ul><ul><ul><li>Updates to medical & family history </li></ul></ul><ul><ul><li>List of </li></ul></ul><ul><ul><ul><li>Risk factors </li></ul></ul></ul><ul><ul><ul><li>Recommended interventions & treatment options, including associated risks </li></ul></ul></ul><ul><ul><li>Personalized health advice </li></ul></ul><ul><ul><li>Referral to preventive & educational programs </li></ul></ul><ul><ul><li>List of all health care providers & suppliers </li></ul></ul><ul><ul><li>Screening schedule for next 5-10 years </li></ul></ul>
  12. 12. Rumor. . . You will lose your MA plan Because of Health Care Reform.
  13. 13. Medicare Advantage Plans <ul><li>Have the choice EVERY YEAR </li></ul><ul><ul><li>to continue coverage </li></ul></ul><ul><ul><li>what additional coverage they may offer every year </li></ul></ul><ul><ul><li>what to charge members in premiums and co-pays or co-insurance </li></ul></ul>
  14. 14. MA Plans in the Future <ul><li>Some plans may leave the Medicare market </li></ul><ul><li>May start charging higher premiums </li></ul><ul><ul><li>Already charge up to $196.00/mo </li></ul></ul><ul><li>May increase copays and coinsurance </li></ul><ul><li>May reduce extra benefits </li></ul><ul><ul><li>No more free health club membership </li></ul></ul><ul><ul><li>Vision coverage </li></ul></ul><ul><ul><li>Dental Coverage </li></ul></ul><ul><ul><li>Hearing Coverage </li></ul></ul>
  15. 15. Why will this happen? <ul><li>Right now Medicare pays MA plans over $1,000 more per person on average than Original Medicare </li></ul><ul><li>These payments are paid for by ALL Medicare beneficiaries through their Part B premiums </li></ul><ul><li>The new law gradually decreases the overpayments to Medicare Advantage Plans </li></ul>
  16. 16. What about my Doctor? <ul><li>You choice of doctor will be preserved. </li></ul><ul><li>The law will increase the number of primary care doctors, nurses, and physician assistants </li></ul><ul><li>Support for community health centers will increase, allowing them to serve 20 million new patients. </li></ul>
  17. 17. What happens now? <ul><li>You will have the same options you always have. . . </li></ul><ul><li>Original Medicare + Supplement + Part D </li></ul><ul><li>Original Medicare + Part D </li></ul><ul><li>Medicare Advantage Plan with Part D </li></ul><ul><li>Medicare Advantage Plan + Part D </li></ul>
  18. 18. How will this benefit my family? <ul><li>Long Term Care </li></ul><ul><ul><li>Elder Justice Act, helps prevent and combat elder abuse and neglect, and improves nursing home quality. </li></ul></ul><ul><li>Creates a new voluntary insurance program called CLASS to help lay LTC and support at home </li></ul><ul><li>Improves HCBS and no longer forces the spouse into poverty </li></ul>
  19. 19. People with Pre-existing Conditions <ul><li>Too young for Medicare, have a health condition? </li></ul><ul><ul><li>Before ACA no insurance for you! </li></ul></ul><ul><ul><li>After ACA </li></ul></ul><ul><ul><ul><li>Transitional high risk pool program for people without insurance </li></ul></ul></ul><ul><ul><ul><li>By 2014 insurance companies will no longer be able to deny adults not on Medicare do to prior health conditions </li></ul></ul></ul><ul><ul><ul><li>Starting in September they can no longer deny children </li></ul></ul></ul>
  20. 20. Preventing Fraud <ul><li>New tools will be implemented to prevent Medicare Fraud! </li></ul><ul><li>By reducing payment errors, waste, fraud and abuse Medicare will save $$$ and return money to the Trust Fund extending the life of Medicare by 12 years! (from 2019 to 2031) </li></ul><ul><li>By 2018 Medicare Beneficiaries can expect to save over $200 per year on premiums and co-insurance amounts compared to what they would have paid without the new law. </li></ul>
  21. 21. <ul><li>Questions? </li></ul><ul><li>Concerns? </li></ul><ul><li>What more do you want to know? </li></ul><ul><li>Contact </li></ul><ul><li>Sarah Taylor, Sedgwick County Extension </li></ul><ul><li>660-0100 ext. 0117 </li></ul>