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Elizabeth Bemis

By: Elizabeth Bemis on March 28th, 2013

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7 Eye-Opening Facts You Didn’t Know About Medicare

assisted living  |  Healthcare For Senior Adults  |  Health Tips for Senior Citizens  |  Aging & Caregiving

medicare facts

How much do you really know about your Medicare program? Since the many hot-media-debates, the dust is finally settling on the real facts. Medicare is the premier healthcare coverage for seniors with over 47 million enrollees and growing rapidly; yet its coverage is like a puzzle with many moving parts. Just when you thought you had it figured out, the Affordable Care Act (ACA) comes along and throws you back off track. The thing is, Medicare is not just a government hand-out you accept at age 65--it’s something you’ve earned--and can claim based on facts. Here are seven (7) surprising facts you may not have known about Medicare.

FACT 1: Medicare has Evolved into ‘Preventive Healthcare’ for Seniors

If it weren’t for healthcare reform many seniors would not go to a doctor, much less consider regular checkups. Now, with a preventive-care policy you can see your doctor for FREE screenings; these include:

  1. Check-ups for diseases such as diabetes, cancer and heart disease
  2. Procedures such as mammograms, colonoscopies, bone-mass measurements and flu-shots
  3. A yearly Wellness Program incorporating relaxation exercises (and other forms), nutrition and more

You’ll also get more in your pocket when the donut hole closes. It’s good news for seniors in assisted living communities and similar settings where savings help with monthly obligations. In the meantime you’ll receive 50% discount on ‘brand’ prescription drugs and subsidies (14%) on generics.

FACT 2: Without Reform, Medicare Would’ve been Bankrupt in Four (4) Years

In 2010, the cost of giving seniors health benefits was $516 billion! Congress projected this amount would grow annually by 7 percent causing the Hospital Insurance Fund to collapse by 2017. Through strategic cuts (reigning-in $716 billion of wasteful spending), the government can fund the parts that need fixing.

FACT 3: The ACA has Breathed New Life into Medicare

With healthcare reform, rather than becoming insolvent in 2017, the life of Medicare Part A will be extended until year 2024 due to massive savings, after which Medicare will still pay 90% of expenses.

FACT 4:  Individual States Will Not ‘Cop-Out’ Of Health-Care Reform Expansion

If individual states accept the provisions to expand Medicaid (a net for lower-income families and the elderly) the federal government will cover 100% of the costs of healthcare for three years. This means your doctor’s visits and hospital stays will be fully covered by the state. It’s a win-win for each state and its residents; if a state refuses to comply--penalties will fall.

FACT 5: The Medicare Drug Savings Act 2011 “Died” for Fear of Premium Hike

In June 2011, President Obama pushed for the Medicare Drug Savings Act which would’ve reverted health benefits to the ‘good old days’ when pharmaceuticals were required to pay rebates for low income beneficiaries (2003). According to Congress these rebates would have provided an extra $112 billion in health benefits from 2012 to 2021.

FACT 6: Cuts to Medicare Advantage (MA) Means More Savings for Seniors

Healthcare for seniors got a boost in the pocket owing to MA cuts. The new law eliminates wasteful overpayments (which amounted to an extra $1,000 per person per year) to private MA insurance plans. Health reform keeps MA more in line with traditional Medicare such as forbidding MA to charge higher on co-payments.

FACT 7: Medicare Premiums Have Been Reduced

For most healthcare seniors Part B deductibles (doctor services and preventive services) have actually REDUCED by $22.00. It reduced from--$162 in 2011 to $140 in 2012—a saving of 13.6%.

Key Takeaways:

  • Seniors, including those in assisted living centers no longer need to postpone preventive care because of costs. Screenings are free and include: wellness visits, cancer diagnostics and personalized prevention plans.
  •  The ‘old Medicare’ wasn’t working and would’ve become insolvent by 2017 if Reform wasn’t enacted.
  • Healthcare for seniors was predicted to continue its downward spiral, but with savings from ACA its new projection is long term.
  • For those eligible for Medicaid, your doctor’s visits and hospital stays will be fully covered once Medicaid expansion takes effect. If a state refuses to comply--penalties will fall hard.
  • The Obama-proposed Medicare Drug Savings Act (2011) would have provided an extra $112 billion in benefits for low income families and seniors from 2012 to 2021.
  • Healthcare for seniors just got better owing to MA cuts, which was a burden to tax payers.
  • Part B deductibles have REDUCED by $22.00 putting more into your pockets since Medicare Reform.

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About Elizabeth Bemis

In 1998, I drove past an assisted living community construction site, learned that it was part of United Methodist Homes and realized the next stop on my professional journey was to work for a mission driven organization. Soon after, I joined the team as Executive Director of our Middlewoods of Farmington community and later served as Regional Manager for the Middlewoods properties before accepting my current role as Vice President of Marketing, Promotions, and Assisted Living Operations. I enjoy spending time with my family, cooking, reading, walking, and love working alongside our staff, residents, and families to build strong communities that reflect the mission, vision, and values of United Methodist Homes.

Our Blog is a 2016 Platinum Generations Award Winner! The Generations Award is an annual international competition for excellence in senior marketing recognizing professionals who have communicated to the 50+ Mature Markets.