“The confusion, uncertainty over access to healthcare services, and costs is chaotic, and a lot could go wrong,” says Cates.
Alexandria, VA (PRWEB) January 06, 2014
Seniors need to take steps now to prevent unexpected healthcare costs that could blow a big hole in household budgets warns The Senior Citizens League (TSCL). More than 57.5 million Social Security recipients are starting 2014 with only a 1.5% boost to their benefits — one of the lowest cost-of-living adjustments (COLAs) ever paid. A COLA of that size will only raise the average Social Security payment about $18.00.
With the start of the Affordable Care Act (also known as Obamacare), “Even seniors on Medicare are at risk of Obamacare-related cost traps, says TSCL Chairman, Ed Cates. Obamacare cuts about $156 billion from Medicare Advantage plans over ten years and some of the biggest Medicare health plans are ending contracts with doctors and major hospitals in 2014. “The confusion, uncertainty over access to healthcare services, and costs is chaotic, and a lot could go wrong,” says Cates. TSCL has put together a list of 4 questions that consumers should ask, and tips on what to do to head off the unexpected:
1. Does your doctor, hospital, and pharmacy still participate in your health plan? Whether your healthcare provider participates in your plan makes a huge difference in what you pay. Both Medicare Advantage and new exchange health plans are restricting their provider networks. Check with your health plan prior to appointments, or filling prescriptions to make sure your doctor, hospital, pharmacy or other providers still are in your plan. You can visit your health plan’s website directly to check the list of participating providers, or call your plan’s customer service number. Always confirm the information you are given with the provider.
2. Did you pay your first premium, and receive your new plan’s membership card? If you’ve recently made a change to your Medicare Advantage or Part D plan, or, if you’ve enrolled in a new Obamacare exchange plan, you need to pay the first premium right away, usually before January 1st for coverage to start by that date. If it’s been more than two weeks since you enrolled, and you haven’t received your new welcome kit and membership card, call the insurer immediately. Have a copy of the name of the plan and confirmation number that you received when you enrolled handy. To be charged correctly for health care services and prescriptions, your doctor or pharmacy needs a copy of your plan membership card.
3. How much is your plan’s deductible and how does it work? A deductible is the amount you pay out – of – pocket before your health plan coverage kicks in. Many of the new Obamacare plans with the lowest premiums, come with steep deductibles — as much as $6,000. If you have a health condition that requires frequent visits to the doctor and tests, this could leave you paying for most of your care out – of – pocket. Learn how the deductible in your plan is applied. Some plans apply the deductible up front to all services and prescriptions but others may apply it only after a certain number of visits to the doctor or to the more expensive non-preferred and brand name drugs.
4. Are you paying a higher premium than you expected? Many people who enrolled in an Obamacare plans have learned that they aren’t entitled to a premium subsidy as high as they thought they would get, and they must pay higher premiums. If this happens you can appeal, but that takes weeks to get a determination. Try shopping again to see if there are alternate choices now before Obamacare Open Enrollment ends on March 31, 2014. Seniors in Medicare Advantage and Part D plans who are having trouble affording their drug costs can apply for Medicare “Extra Help,” a program that provides low-income seniors with assistance that covers part or all of premiums and out – of – pocket costs. Seniors can apply online at http://www.SocialSecurity.gov or contact your local Area Agency on Aging for help to apply.
How are healthcare costs affecting you in 2014? Your experience counts! Sign up to participate in TSCL’s annual 2014 Senior Survey that will be conducted in January and receive TSCL’s free online newsletter The Social Security & Medicare Advisor. To learn more, visit TSCL at http://www.SeniorsLeague.org.
With about 1 million supporters, The Senior Citizens League is one of the nation's largest nonpartisan seniors groups. Located just outside Washington, D.C., its mission is to promote and assist members and supporters, to educate and alert senior citizens about their rights and freedoms as U.S. Citizens, and to protect and defend the benefits senior citizens have earned and paid for. The Senior Citizens League is a proud affiliate of TREA The Enlisted Association. Please visit http://www.SeniorsLeague.org or call 1-800-333-8725 for more information.