Improving the lives of older Americans
Straight Talk WebinarWELCOME
This session will begin promptly at 3:30pm ESTPlease mute your phone
To hear the audio, please dial 1-866-740-1260 x4796970
The moderator will be on the line shortly
Improving the lives of older Americans
Straight Talk for Seniors:How Will Health Care Reform Change Your Health
Care?
September 2010
© 2009. National Council on AgingA non-profit service and advocacy organization
Improving the lives of older Americans since 1950
National Council on Aging (NCOA)
Enhancing Economic Security
Improving Health
Strengthening Community
Organizations
© 2009. National Council on AgingA non-profit service and advocacy organization
Our Goal Today
Just the Facts, Ma’am. Just the Facts.
© 2009. National Council on AgingA non-profit service and advocacy organization
Just the Facts About….
The A-B-C-D’s of Medicare
Health Reform Changes to Medicare Finances
How Health Reform Changes Affect YOU
© 2009. National Council on AgingA non-profit service and advocacy organization
The ABCD’s of Medicare
1
© 2009. National Council on AgingA non-profit service and advocacy organization
Medicare is Difficult to Understand!
© 2009. National Council on AgingA non-profit service and advocacy organization
The A-B-C-D’s of Medicare
Part A – Hospital Insurance• Inpatient care,
including skilled nursing
• Paid for by payroll taxes
• Concerns about future solvency
© 2009. National Council on AgingA non-profit service and advocacy organization
The A-B-C-D’s of Medicare
Part B - Outpatient Health Insurance
• Pays for additional medical services (like doctors visits, diagnostic tests, and outpatient care)
• Financed 75% by general revenues, 25% by monthly premiums ($96.40 or $110.50 in 2010)
© 2009. National Council on AgingA non-profit service and advocacy organization
The A-B-C-D’s of Medicare
Part C - Medicare Advantage (MA)
• Private health plans (e.g. HMOs and PPOs) that deliver Medicare services
• 24% of Medicare recipients are in MA
C
© 2009. National Council on AgingA non-profit service and advocacy organization
The A-B-C-D’s of Medicare
Part D - Prescription Drug Coverage• You choose your plan
• Includes a coverage gap for “donut hole”
• Paid for by general revenues 2003 law was not paid
for
© 2009. National Council on AgingA non-profit service and advocacy organization
The A-B-C-D’s of MedicareMany believe that rate of spending on
Medicare cannot be sustained
3.56.4
2010 2030
Medicare as a Percentage of GDP• Medicare spending is
increasing faster than the rest of the economy.
4679
2010 2030
Millions with Medicare• The number of people
with Medicare will grow rapidly as Boomers age.
© 2009. National Council on AgingA non-profit service and advocacy organization
Health Reform Changes to Medicare Finances
2
© 2009. National Council on AgingA non-profit service and advocacy organization
The Basic Math of Medicare Under Health Reform
$7.15 TRILLION = Projected total Medicare spending before health reform (2010 -2019)
$6.75 TRILLION = Projected total Medicare spending after health reform (2010-2019).
-$400 BILLION = Net 10-year reduction in overall Medicare spending due to health reform (from 6.8% average yearly increases to 5.7% yearly increases). Net reduction in per capita spending (after inflation) from 4% to 2% annually
But Remember:+ $500 BILLION = Net 10-year increase in Medicare spending
due to 2003 Medicare prescription drug law (not paid for).
© 2009. National Council on AgingA non-profit service and advocacy organization
Questions about Health Reform and Medicare
The new law will result in future cuts to your basic Medicare
benefits.
True, False, Don’t Know
© 2009. National Council on AgingA non-profit service and advocacy organization
Financial Changes to Medicare
Increased Revenues• Higher payroll taxes for wealthy
workers ($200/$250,000)• Higher Part D premiums for 5% of
higher-income Medicare beneficiaries ($85/$170,000)
Reduced Spending• Slower growth in payments to
providers (not doctors)• Reduction in over-payments to
Medicare Advantage plans• Average yearly Medicare spending
increases down from 6.8% to 5.7 % overall or from 4% to 2% per person
© 2009. National Council on AgingA non-profit service and advocacy organization
Health Reform Financial Changes to Medicare
Medicare solvency extended for 12 more years
Increased funding to improve some Medicare benefits
© 2009. National Council on AgingA non-profit service and advocacy organization
What About the Federal Budget Deficit?
!Congressional Budget Offices estimates
health reform will save $124 billion over 10 years.
© 2009. National Council on AgingA non-profit service and advocacy organization
How Health Reform Changes Affect You
3
© 2009. National Council on AgingA non-profit service and advocacy organization
Questions about Health Reform and Medicare
The health care reform law will cut Medicare payments to doctors.
True, False, Don’t Know
© 2009. National Council on AgingA non-profit service and advocacy organization
How These Changes Affect YOU
Changes in Doctor Payments
The law provides a 10% bonus for primary care doctors
The law did not address the long-standing problem of future cuts in doctor fees, which has been a problem for more than 10 years, but that Congress consistently delays in separate bills.
© 2009. National Council on AgingA non-profit service and advocacy organization
How These Changes Affect YOU
Improvements in Medicare Prescription Drug Coverage
• $250 Rebate Check for those who hit donut hole
• 2011: 50% discounts on brand name Rx
• 2020: Coverage gap completely closed
© 2009. National Council on AgingA non-profit service and advocacy organization
How These Changes Affect YOU
Better Preventive Care
• Free annual wellness visit and prevention plan
• No more cost sharing – most preventive benefits free
• More funding for prevention services
© 2009. National Council on AgingA non-profit service and advocacy organization
How These Changes Affect YOU
New quality improvements Pilot projects and
demonstrations to test better coordination among doctors, specialists, other providers
Incentives to reduce hospital readmissions
Help so you can manage your own care
Better Chronic Care
© 2009. National Council on AgingA non-profit service and advocacy organization
How These Changes Affect YOU
Other ImprovementsIncentive to companies to help keep premiums down for early retirees
New protections against elder abuse, neglect, financial exploitation
Better training for workers caring for seniors
Nursing home quality improvements
+
© 2009. National Council on AgingA non-profit service and advocacy organization
How These Changes Affect YOU
Greater Access to Medicaid Home and Community Long-Term Care Services• Help to stay at home – if your state
adopts these important options
• Financial protections for spouses
• Program to leave nursing homes
• Voluntary public long-term care insurance program for full and part-time workers (CLASS)
© 2009. National Council on AgingA non-profit service and advocacy organization
How These Changes Affect YOU
What about Medicare
Advantage Plans?
© 2009. National Council on AgingA non-profit service and advocacy organization
Question on Health Reform and Medicare Advantage
Under the new health reform law, the Medicare Advantage (MA) program will be eliminated. • True, False, Don’t Know
© 2009. National Council on AgingA non-profit service and advocacy organization
Question on Health Reform and Medicare Advantage
Under the new health reform law, Medicare Advantage plans will
cut benefits and increase premiums.
• True, False, Don’t Know
© 2009. National Council on AgingA non-profit service and advocacy organization
Reduced Payments to Medicare Advantage Plans
MA plans are paid about $1,100 more per person than people in original Medicare (13% higher)
Payments frozen in 2011
Beginning in 2012, these overpayments will be gradually reduced
© 2009. National Council on AgingA non-profit service and advocacy organization
How These Changes Affect YOU
Changes in Medicare Advantage (MA) Plans?
•Some plans may eventually reduce extra benefits, increase premiums or even leave the program
•New bonuses to reward high quality care
•New consumer protections to limit out-of-pocket costs
© 2009. National Council on AgingA non-profit service and advocacy organization
If you have a Medicare Advantage plan
1. Don’t panic, but get informed.
2. Shop around – research your options at www.MyMedicareMatters.org.
3. Learn if you are eligible for Medicare Savings Programs, Extra Help for Prescription Drugs and/or other benefits (go to www.benefitscheckup.org).
4. You can always return to Original Medicare.
© 2009. National Council on AgingA non-profit service and advocacy organization
How Health Reform Affects Your Children and Grandchildren
• Children up to age 26 will be covered under their parent’s policies (2010)
• No one will be denied coverage because of pre-existing conditions or dropped because they get sick (2011)
Insurance Protections
© 2009. National Council on AgingA non-profit service and advocacy organization
How Health Reform Affects Your Children and Grandchildren
•CBO estimates that 32 million currently uninsured Americans will have health insurance.
•New tax credits and tools will help contain costs and improve quality – so we all get better VALUE.
© 2009. National Council on AgingA non-profit service and advocacy organization
Five Facts – The New Law Will:
1.Not cut your basic Medicare benefits — and it will make some benefits better.
2.Reduce Medicare spending and the federal deficit, and extend Medicare’s solvency by twelve years.
3.Help people find and pay for long-term care at home.
4.Improve health care for seniors in other ways.5.Improve coverage and protections for younger
Americans with and without health insurance.
© 2009. National Council on AgingA non-profit service and advocacy organization
Our Goal Today
How did we do?What questions do you have?
Just the Facts, Ma’am. Just the Facts.
Improving the lives of older Americans
Straight Talk for Seniors:Will Health Care Reform Change Your Health
Care?For more information:www.NCOA.org/StraightTalk
www.medicare.gov1-800-MEDICARE
Local Health Insurance Counseling Office