Phil Castell
Castell Insurance
426 E. Washington St., Sequim, WA 98382
Phone: 360-683-9284 • Fax: 360-683-9026
Phil@CastellInsurance.com
www.CastellInsurance.com  

 

In writing my articles, I generally research different Web sites for information. One that is a great source is the www.Medicare.gov site.

This month's article is taken directly from that site and has been abridged only to fit the space allocated for my article.

The following information is from a new Medicare brochure (publication 11467) entitled "Medicare and the New Health Care Law - What It Means For You."

The Affordable Care Act passed by Congress and signed by President Obama this year will provide you and your family greater savings and increased quality health care. It also will ensure accountability throughout the health care system so that you, your family and your doctor - not insurance companies - have greater control over your care.



Benefits unchanged

These are needed improvements that will keep Medicare strong and solvent. Your guaranteed Medicare benefits won't change - whether you get them through original Medicare or a Medicare Advantage plan. Instead, you will see new benefits and cost savings and an increased focus on quality to ensure that you get the care you need.

The guaranteed Medicare benefits you currently receive will remain the same. During open enrollment this fall, you will continue to have a choice between original Medicare and a Medicare Advantage plan.

Medicare will continue to cover your health costs the way it always has, and there are no changes in eligibility. But there are some important benefits that you and your family can take advantage of starting this year.



'Donut hole'

If you enter the Part D "donut hole" this year, you will receive a one-time $250 rebate check if you are not already receiving Medicare Extra Help. These checks will begin mailing in mid-June and will continue monthly throughout the year as beneficiaries enter the coverage gap.

Next year, if you reach the coverage gap, you will receive a 50-percent discount when buying Part D-covered brand-name prescription drugs. Over the next 10 years, you will receive additional savings until the coverage gap is closed in 2020.

Next year you can get free preventive care services such as colorectal cancer screening and mammograms. You also can have a free annual physical to develop and update your personal prevention plan based on current health needs.



Medicare Advantage

Today, Medicare pays Medicare Advantage insurance companies $1,000 more per person on average than original Medicare. These additional payments are paid for in part by increased premiums by all Medicare beneficiaries - including the 77 percent of seniors not enrolled in a Medicare Advantage plan.

The new law levels the playing field by gradually eliminating Medicare Advantage overpayments to insurance companies.

If you are in a Medicare Advantage plan, you still will receive guaranteed Medicare benefits. Beginning in 2014, the new law protects Medicare Advantage members by taking strong steps to ensure that at least 85 percent of every dollar these plans receive is spent on health care rather than administrative costs and insurance company profits.



Combats abuse

New tools and resources in the Elder Justice Act, which was included in the new law, will help prevent and combat elder abuse and neglect and improve nursing home quality. The new law creates a new voluntary insurance program called CLASS to help pay for long-term care and support at home.

Individuals on Medicaid will receive improved home- and community-based care options, and spouses of people receiving home- and community-based services through Medicaid no longer will be forced into poverty.

To help offset the cost of employer-based retiree health plans, the new law creates a program to preserve those plans and help people who retire before age 65 get the affordable care they need.

The new law provides affordable health insurance through a transitional high-risk pool program for people without insurance due to a pre-existing condition. Insurance companies will be prohibited from denying coverage due to a pre-existing condition for children starting in September and for adults in 2014. Insurance companies will be banned from establishing lifetime limits on your coverage and use of annual limits will be limited starting in September.

If you have any questions about the above, contact Medicare at 800-MEDICARE,or I will do my best to answer any questions locally.



Phil Castell is an independent insurance agent in Sequim. He can be reached at 683-9284 or PhilCastell@msn.com.