How "Obamacare" will affect Medicare, and where to turn for advice

Published on Wed, Oct 9, 2013 by Ian Ferguson

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Politics aside, the changes brought about by the Affordable Care Act (aka “Obamacare”) can be confusing for anyone. With the Medicare open enrollment period beginning October 15, now is a great time for seniors to learn more about how their plans might be affected, and the options available to them.

The good news for seniors is that the newly passed law will have no effect on how Medicare works. Seniors can still shop for new plans, change plans or update their old plans as they always do during the open enrollment period, which runs from October 15 through November 7 this year.

“The Affordable Care Act won’t be administered through Medicare, so it won’t change the Medicare process,” said Rod Bring, 
vice president of life and health at Blaine Insurance.

The law will, however, cause minor changes to some plans. The law will expand Medicare benefits for certain plans – things like preventive benefits, cancer screenings and annual wellness visits. It will also provide discounts on brand-name prescription drugs for those who fall in the prescription drug “doughnut hole” – a gap in coverage that affects some people who are enrolled in original Medicare with a supplemental drug coverage (aka “Part D”) plan.

The new law will also increase monthly premiums and certain copay expenses for those who have a Medicare Advantage plan.

“Medicare Advantage plans are funded by the federal government through contracts with private insurance companies, and some of that funding will be re-allocated to support the Affordable Care Act,” explained Jeff Gassman, a broker with United Insurance Group. “Most carriers will increase their monthly premiums and copays for certain services, and that’s what we’re seeing here in Whatcom County.”

Gassman cited plans from two competing Whatcom County insurance companies: a Group Health plan, with premiums increasing from $43 to $78 per month, and a Soundpath Health plan with premiums increasing from $28 to $34 per month.

For those with a Medicare Advantage plan, “It’s important to take a look at your annual notice of change letter to find out what changes are in store for 2014,” Gassman said. Annual notice of change letters are sent out in September.

Even those who are happy with their Medicare plan may find cost savings and/or better coverage under a different plan. With open enrollment approaching, now is a great time to meet with an advisor face-to-face to learn what your options are. 

Here are a few free resources available to seniors seeking Medicare advice:

Statewide Health Insurance Benefits Advisors (SHIBA): This network of volunteer advisors provides free, unbiased and confidential assistance with Medicare and health care decisions. Advisors are trained and available in local communities throughout Washington. 

The local office is Whatcom Alliance for Healthcare Access, 800 E Chestnut Street, Lower Level, Suite 2, Bellingham. The phone number is 360/788-6587.

Whatcom County Aging and Disability Resources Program (ADRP): This program offered by the Northwest Regional Council provides seniors with the latest information on medical and dental insurance coverage, including Medicare, Medicare Advantage plans, Medigap policies and Medicare prescription drug coverage. 

Call 360/738-2500 or email adrcwhatcom@dshs.wa.gov to set up an appointment.

Information session at the Blaine Senior Center: Representatives from ADRP and SHIBA will host a Medicare open enrollment information session open to all on Tuesday, October 29 at 11:45 a.m. The Blaine Senior Center is located at 763 G Street.

Licensed insurance professionals: Insurance brokers are annually trained and certified in the policies they provide, so they know more about the process than anyone else. As Bring said, “We do it for a living.” 

Blaine Insurance offers health insurance products from multiple carriers, as well as car, home, business and life insurance. 

They are located at 838 Peace Portal Drive and their phone number is 360/332-7300. 

Gassman and his wife Mary are both licensed, certified insurance brokers who have been operating out of Bellingham for going on 11 years. 

They offer products from multiple carriers, make house calls and can be reached toll-free at 800/551-0080, extension 5169.

Insurance agents are obligated by their license to provide free consultation, so if an agent tries to charge for consultation, see someone else.

If you suspect your insurance provider is acting fraudulently you can call 1-800-MEDICARE.