What impact does the New Health care Reform Law have ?
ORIGINAL MEDICARE (Parts A & B)
Payroll taxes paid by employees, employers, and self-employed individuals; funds authorized by Congress; and premiums paid by Beneficiaries.
NO, unless changed by an Act of Congress.
Part A is Hospital Insurance. Part B is Medical Insurance.
Part A and Part B provides the same coverage for everyone.
YES, just about all doctors and hospitals accept Medicare Assignment.
The guaranteed Medicare benefits you currently have will remain the same. Beginning in 2011. Part B will cover a free annual physical. You will pay NO deductible or
Private Insurance Companies
The plan receives a fixed amount per enrollee per month from Medicare plus the Beneficiary's Part B premium. Many plans will also charge a monthly premium to the member/policy holder.
YES, Contracts operate on an annual basis upon approval by CMS.
At least what Original Medicare covers plus additional benefits not covered by Medicare.
The insurance company generally offers a choice of plans with varying co payments and costs. Most plans include prescription drug coverage. Some plans add dental and/or vision coverage.
It depends on whether your doctor accepts your plan. You may only use the providers that are in your plans network
Generally, YES. Penalties may apply if you do not follow the plan's rules.
Today, Medicare pays Medicare Advantage insurance companies over $1,000 more per person on average than Original Medicare. You still receive guaranteed Medicare benefits, but these over payments will be gradually eliminated starting in 2012. Beginning in 2014, at least 85% of every dollar these plans receive must be spent on health care, rather than administrative costs and insurance company profits.
Private Insurance Companies
Premiums paid by the policy holder.
NO. Once you purchase a policy it can only be terminated if you do not pay your premium on time or you made a material misrepresentation on your application.
Depending on the plan letter you purchased, your policy will pay some or all of the out-of-pocket expenses that are left after Medicare Part A and B pays their portion, such as deductibles, copays, and co-insurance. For example, Plan F- the most comprehensive plan- covers all out of pocket costs.
There are 10 uniform plans- letters A through N- that are standardized and regulated by the government to be identical across all insurance companies that offer them. The most popular plans are Plan F, G and N.
YES, your plan must automatically be accepted by any doctor, hospital, or healthcare provider that takes Medicare.
NONE. The good news is that once you have a Medicare Supplement policy, it cannot be changed except to coincide with changes to Medicare's deductibles,coinsurance, and co payments. For example, if your policy pays the Part A deductible, each year as the Part A deductible increases, your policy will pay the increased deductible.