Medicare beneficiaries will have more of their preventive services and prescription drug costs covered due to changes occurring under the federal Affordable Care Act.
The most important thing that seniors on Medicare need to know, though, is that they do not need to sign up with the new health-care marketplace to get those or other benefits, representatives of AARP said at a workshop Thursday in Minot.
The re-enrollment period to change a Medicare prescription drug plan runs through Dec. 7, but this is not the same as the marketplace.
Doreen Riedman, associate state director of community outreach for AARP, Bismarck, said AARP, a senior advocacy group, has been working to educate its members and others about the new health-care law. It also wants to warn seniors about potential scams that attempt to take advantage of any confusion.
Riedman said Medicare never calls seniors to try to enroll them. People should ignore calls from strangers offering to help them enroll, typically for a price.
Misinformation about the health-care law's effect on Medicare, such as reports of loss of dialysis or cancer treatment, also have spread quickly over the Internet. Using reliable, fact-checking websites can help people sort out the truth, Riedman said.
Josh Askvig, associate state director of advocacy for AARP, Bismarck, said Medicare beneficiaries will find their benefits are improving.
"It covers more preventive services and lowers some out-of-pocket costs," he said. "You now have access to a yearly wellness visit without a co-pay or co-insurance."
The wellness visit is different from a physical, which is a more extensive exam. The visit would include a review of medical and social history, counseling about preventive services, blood pressure checks, a simple vision test, calculation of body mass index, review of the potential risk for depression or safety issues and a written plan outlining needed screenings and other preventive services.
"Additional screening for diabetes and certain cancers are also covered now. The focus is on getting people to think prevention," Askvig said.
Cognitive screening is a new screening that will be covered.
The so-called "doughnut hole" also is closing under the health-care law. The coverage gap can occur in the Medicare Part D prescription drug program when expenses reach a certain point.
Under the health-care law, Medicare Part D beneficiaries will receive a 52.5 percent discount for brand-name drugs and a 21 percent discount for generic drugs if they fall into this coverage gap. That discount will increase to 70 percent for brand-name drugs and 63 percent for generic drugs by 2019. The doughnut hole will disappear in 2020.
Medicare beneficiaries in a Part D plan do not need to re-enroll, but AARP encourages people to review their plan annually.
"We always recommend to take a look at it every year because there might be something better out there for you," Askvig said.
"If your medication changes, your policy needs may change, too," Riedman added. "A different policy may suit you better."
Medicaid, a low-income program with federal and state funding, is expanding in North Dakota with the state's decision to participate in that piece of the health-care law. This Expanded Medicaid program will increase the number of people eligible by including individuals and families at or below 133 percent of poverty. For a family of four, an income of $32,499 would be 133 percent of poverty.
Expanded Medicaid differs from the current Medicaid and remains a separate program, Askvig said. People enrolled in the expanded program will be covered through a plan funded through the state but offered privately by Sanford or Blue Cross Blue Shield of North Dakota.
The sign-up period for Expanded Medicaid began this month through the North Dakota Department of Human Services.