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October 15, 2013
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11 questions about the Affordable Care Act

Editor’s Note: Senior Advisory Council member Paul Lockwood submitted this list of 11 questions asked by seniors about how the Affordable Care Act would affect them. The R-C submitted the questions to the Nevada Division of Insurance and Medicare. We heard from the state, but they said the questions would best be answered by the Centers for Medicare & Medicaid Services. When we hear from the federal government, we’ll publish those answers.

1. How do seniors verify that their current health insurance plan is in compliance with the Affordable Care Act? Who should they call, since many older seniors don’t have access to the internet?

Seniors would not need to verify Medicare plans because Medicare is a federal program that has different requirements than ACA compliant plans offered by private insurers. If seniors have retirement insurance it’s not likely to have been significantly affected by the ACA, but seniors can call their insurance carrier for verification.

2. What are the most important items seniors should know concerning the changes in medical insurance and coverage as a result of ACA?

There are two noteworthy changes to Medicare. First, the donut hole of Medicare Part D (drug coverage) is closing and generic drugs will be provided discounts. The donut hole is that area between where catastrophic coverage kicks in and the drug co-payment only zone ends. Second, Medicare also offers more preventive services as a result of the ACA.

3. Will the cost to seniors for the health care costs, not covered by the combination of Medicare and Medigap (supplement insurance) insurance, increase as a result of ACA?

The DOI does not have sufficient information to provide an answer.

4. Does ACA change the eligibility requirements for Medicaid in Nevada? If so, what are the changes? Does a senior need to apply for a federal account number to get Medicaid coverage?

Yes, eligibility for Medicaid in Nevada has been expanded to 133 percent of federal poverty level, but there are no changes for the aged, blind, and disabled. Seniors fall into the aged category.

It is now an option to sign up for Medicaid on the Nevada Health Link (also know as the Silver State Health Insurance Exchange). You can call Nevada Health Link at (855) 768 5465 or The Division of Welfare and Supportive Services in Carson City, 2533 North Carson Street, Suite 200, or by phone at 684-0800.

The State of Nevada has a “No wrong door policy.” This means for example that if a person goes to the exchange to sign up for Medicaid, or the DWSS, either way they will be able to obtain the necessary information and support.

4. Will the cost of Medicare and Medigap supplement insurance premiums be changed (increased or decreased) as a result of ACA?

The DOI does not have sufficient information to provide an answer.

5. Should seniors look into changing their Medicare Part D prescription plan as a result of ACA? Will the cost of Part D insurance change significantly?

Seniors should review their needs and available alternatives every year during the open enrollment period Oct. 15-Dec. 7. Part D premiums should not be affected but the shrinking of the donut hole and drug discounts should provide savings for seniors.

7. What are the medical insurance requirements for undocumented senior immigrants as a result of ACA?

Undocumented immigrants are not eligible to participate in the exchange.

8. Will a medical insurance company be able to deny a senior Medicare supplement insurance if they have a severe incurable health problem?

If the senior misses the deadlines to sign up, then yes the company can deny coverage. Even if a senior makes the deadlines, depending upon circumstances, the insurance company could impose a six-month waiting period on pre-existing conditions. Contact The State Health Insurance Program (SHIP) for details at 800-307-4444.

9. Has the eligibility requirements for the Low-Income Subsidy plan for prescription drugs in Nevada been changed as a result of ACA?

We are not aware that the ACA has not affected this program.

10. As a result of ACA, have there been any changes in Medicare and Medicaid long-term care benefits for seniors who have a chronic illness or disability?

Generally, no.

11. As a result of ACA, will seniors in Douglas County have a more difficult time locating medical doctors who will accept them as patients?

We can’t speculate on this.

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The Record Courier Updated Oct 15, 2013 02:42PM Published Oct 15, 2013 02:42PM Copyright 2013 The Record Courier. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.