Medicare Watch

Call for Exchanges to Include Medicare-Related Programs

In comments submitted to the Department of Health and Human Services (HHS) on the American Health Benefits Exchanges, the Medicare Rights Center recommended that Exchanges, created by the Affordable Care Act (ACA), include streamlined eligibility screening and enrollment processes for people with Medicare who have low incomes, to make Medicaid and Medicare Savings Programs (MSPs) more accessible.

As a result of the ACA, starting in 2014, individuals and small employers will be able to buy health insurance through Exchanges, where individuals will also be assessed for eligibility for Medicaid and premium subsidies to offset the cost of coverage. In addition, the ACA requires new income budgeting for consumers age 64 and under, which will require states to use modified adjusted gross income (MAGI) to determine eligibility for Medicaid. The law also allows the Internal Revenue Service (IRS) to verify information provided by those consumers on their Medicaid applications, thereby eliminating the need for consumers to provide additional supporting documentation and paving the way for greater automation of enrollment into Medicaid. However, these rules do not apply to Medicare-eligible individuals, whom Medicare Rights calls “non-MAGIs.” As states move forward to establish Exchanges, it is important that enrollment and eligibility systems are designed to include Medicare consumers, and that both the Medicare and non-Medicare populations can access low-income program benefits through streamlined and automated enrollment processes.

Medicare Rights submitted comments on October 4, in response to a request for comments on Exchanges by HHS, published in the Federal Register on August 3, 2010.

Read the Medicare Rights Center’s comments on the American Health Benefits Exchange.

Read HHS’ request for comment on the American Health Benefits Exchange.

Plan Finder Enters 2011

As of today, 2011 plan information is available on Medicare Plan Finder. Plan Finder allows Medicare consumers to compare plans and coverage options—including Medicare private health plans, also known as Medicare Advantage (MA) plans, and stand-alone prescription drug plans—that are available in their area. The Fall Open Enrollment period for the 2011 plan year begins on November 15 and lasts through December 31. While the national average premiums for both MA and prescription drug plans remain relatively stable, some consumers may see an increase in their current plan’s premium in 2011. There are, however, less costly options available in most regions. Medicare Rights strongly urges consumers to examine all of the coverage options available to them to find coverage that is not only economical, but also provides access to services and drugs they need without overly burdensome restrictions.

The Centers for Medicare & Medicaid Services (CMS) updated and redesigned the Plan Finder this year, and offers a tutorial on their website to help users familiarize themselves with the new format.

Use Plan Finder.

Watch the Plan Finder tutorial.

Medicare Reminder

There are different ways to get Medicare health benefits:

1. Original Medicare (traditional fee for service coverage by the federal government) alone;
2. Original Medicare with supplemental insurance, like a Medigap or retiree plan; or
3. A Medicare Private Health Plan (Medicare Advantage plan) like an HMO, PPO or PFFS plan.

Learn more about Original Medicare.

Learn more about Medicare private health plans.

Find answers to your Medicare questions at www.MedicareInteractive.org.

Spotlight

A new report from the Center on Budget and Policy Priorities (CBPP) responds to a recent deficit-reduction proposal that calls for increasing the age of Medicare eligibility from 65 to 67 and reducing the subsidies for low- and middle-income people who purchase health insurance in state-run exchanges. The CBPP’s report argues that this eligibility change, coupled with the subsidy reduction, would raise premiums on the exchanges and undermine health reform.

Read the report.

Take action to preserve Medicare.