Medicare Watch

Medicare Rights Releases New Fact Sheet

Last week, the Medicare Rights Center released a new fact sheet about Medicare’s future and the key role the program plays in keeping American families financially secure. “Medicare: Strong and Built to Last” intends to inform the current deficit-reduction and budget debate that has serious implications for the Medicare program. In response to proposals that would lower the debt only by cutting Medicare benefits or shifting costs to beneficiaries, Medicare Rights’ fact sheet reiterates that rising health care costs in the system overall pose the real problem to deficit-reduction. In fact, Medicare can—and should be—the solution to controlling costs over the entire health care sector: Medicare spending is expected to grow at a lower rate over the next decade than private insurance. Recently proposed models, including the premium support, or voucher, program proposed by vice presidential candidate Paul Ryan, fail to address this underlying cause of increased Medicare spending. Rather, such proposals would only increase the burden on Medicare beneficiaries who can least afford it. Ryan’s proposal would end Medicare as we know it, replacing Medicare’s guaranteed set of benefits with a voucher to purchase health insurance; as the voucher is unlikely to keep pace with inflation, over time, beneficiaries would see their out-of-pocket expenses rise. Half of all people with Medicare earn below $22,000 a year and already spend more than 15 percent of their annual incomes on health care costs. Under the Ryan plan, they would pay roughly $6,400 more a year. “Medicare: Strong and Built to Last” also discusses the successes of the Affordable Care Act (ACA) and how the law extends the lifespan of the Medicare program without cutting benefits.

The Center for Medicare Advocacy (CMA) also offers a helpful guide to parsing fact from fiction about the ACA. With so much confusion and misinformation about the law, CMA’s chart identifies popular myths about the ACA and sets the record straight. Have you heard that the ACA cuts $700 billion from Medicare? It does so not by reducing benefits for the individuals enrolled, but through delivery system innovations, efforts to reduce waste and fraud and new payment reforms, achieving much of its savings by lowering payments to Medicare private health plans that have, historically, been overpaid.

Read Medicare Rights’ fact sheet, “Medicare: Strong and Built to Last.”

Read CMA’s chart, “Medicare Facts & Fiction.”

ACA Strengthens Medicare and Improves Benefits for Those Enrolled

The Center on Budget and Policy Priorities (CBPP) recently posted a blog that aims to correct false claims that the Affordable Care Act (ACA) “robs” Medicare. According to the blog, such claims are “way off base.” The Congressional Budget Office estimates that the ACA will reduce Medicare’s projected spending by $716 billion between 2013 and 2023. CBPP reiterates that these reductions in Medicare’s projected spending improve Medicare, and do not cut guaranteed benefits for beneficiaries.

According to the CBPP, the ACA has improved Medicare and strengthened the program’s finances. The ACA increases the Medicare payroll tax for people earning more than $250,000 a year and reduces overpayments to Medicare private health plans, also known as Medicare Advantage plans. Over the next ten years, these changes will reduce Medicare spending by $716 billion. CBPP emphasizes that these and other savings do not result from cuts to Medicare’s guaranteed benefits. In fact, the ACA adds new preventive services and closes the Part D prescription drug coverage gap, or doughnut hole.

The ACA has also strengthened the Medicare program by prolonging the life of the Medicare hospital insurance trust fund. According to CBPP, the ACA has reduced the size of the trust fund’s 75-year shortfall, and the trust fund will remain solvent through 2024—before health reform, the trust fund was estimated to become insolvent eight years earlier, in 2016.

Read the CBPP blog posts, “Health Reform Strengthens Medicare, Doesn’t ‘Rob’ It” and “Health Reform Strengthens Medicare.”

Medicare Reminder

If you have no symptoms or prior history of breast cancer, Medicare will cover preventive mammograms. Mammograms can detect abnormal tissue and breast cancer. If you have Original Medicare, you do not have to pay a coinsurance or deductible for a screening mammogram if you see doctors who take assignment (accept the Medicare-approved amount as payment in full).

Medicare covers:

• One baseline mammogram for women 35 to 39 years of age;
• One screening mammogram every 12 months for women ages 40 and over.

Medicare will also pay for both men and women to have diagnostic mammograms more frequently than once a year. A diagnostic mammogram may be recommended when a screening mammogram shows an abnormality or when a physical exam reveals a lump. Medicare covers as many diagnostic mammograms as necessary. These mammograms are billed differently than preventive screening mammograms. There is a 20 percent coinsurance for people with Medicare who have already met the Part B deductible.

If you are enrolled in a Medicare private health plan, also known as a Medicare Advantage plan, you do not need a referral for a screening mammogram. In addition, you are not required to pay cost-sharing for this preventive service as long as you see in-network providers, and as long as no diagnosis is made on the basis of the screening mammogram. Contact your plan to find out what other costs and rules apply.

Learn more about coverage of mammogram screenings at www.medicareinteractive.org, or call our helpline at 800-333-4114.

Spotlight

Social Security turned 77 on August 14. To coincide with both the Social Security and Medicare birthdays (Medicare turned 47 on July 30), Social Security Works created a series of 50 state reports on how Social Security, Medicare and Medicaid work for America. Each state fact sheet details how many people receive these benefits, the kinds of protection the programs provide, and how cutting Social Security, Medicare or Medicaid would threaten the economic security and health of families across the country. Available in English and Spanish, the reports recognize the importance of improving and preserving these programs for current and future beneficiaries.

Read Social Security Works’ reports.