Affordable Care Act: The Senior Care Benefits

Affordable Care Act: The Senior Care Benefits

The Patient Protection and Affordable Care Act (ACA) have made a significant contribution to improving the provision of care to the elderly across the country, mainly through the extension and modification of health insurance. Among the many changes, improving Medicare’s efficiency and effectiveness has reduced Medicare Part B monthly premiums. In 2013, the premium was lower than analysts’ forecasts: only $ 104.96; and stayed at $ 104.97 in 2014.

It is impressive in itself and for oneself. But the ACA did much more than keep the cost of Part B low; This also reduces the costs and improves the efficiency of Medicare Part C; the “Medicare Advantage” program, which allows private insurance companies to integrate current Medicare benefits with costs lower than normal.

Medicare Part C

For most seniors, Medicare Part C is the only viable alternative to Medicare Parts A and B, which allows private insurance companies to accept Medicare money to pay a portion of the premiums for seniors. Since payments are shared between the government and the citizen, the latter can afford an insurance that would not otherwise be available, which for most seniors “means insurance that actually insures most of the costs of Health care”.

Under the law, Part C policies have always insured at least the same insurance as Medicare A and B, but they have been at the root of some of the most ingenious developments in the area of ​​personal care older people, including the area of case management and coordination of care. Almost 30% of all beneficiaries of Medicare use Part C of Medicare.

How the ACA has improved an excellent system

The big “challenge” of Medicare Part C was the difference between the amount of private insurance paid to a provider for a given service through Part C and the amount paid by the A / B parties for the same service . Disbursements have varied widely, with some policies paying less than the maximum, but most paying too much for the same service, penalizing “standard” Medicare beneficiaries in the eyes of the medical institution.

For example, the ACA promulgated provisions covering Part C payments to insurance companies within the limit of 5% of “standard Medicare” payments on the basis of “normal and reasonable” fees for each service in the geographical area where the service was provided. They also asked that Medicare Part C policies be sold on the same bursaries as traditional insurance, allowing seniors to compare Medicare Advantage policies and determine which ones are the most convenient and provide the best insurance

The impact of this change is that insurance companies benefit slightly less from each of the C participants that serve, partly because of service disbursements and partly because of price competition caused by barter transactions. However, a much larger number of participants is needed because older people are aware and satisfied with the purchase of Part C when they appear at ACA health posts. The net effect is beneficial for insurance companies: while profits per participant have decreased by about 10%, the number of participants has increased by 33%, so that the final result increases each year.