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Medical Supplemental Insurance

Some Medicare benefits are becoming better due to the Affordable Care Act, popularly referred to as “Obamacare”.  This page will provide you with a quick overview of Obamacare in the Dunkirk, Fredonia, Silver Creek, and Chautauqua County regions.

First of all, you should expect to pay less for your prescription drugs. You will also still be able to choose your own doctor, that fact remains unchanged.

However, there still may be a few things that you need to watch. For example, there are a number of changes that will affect Medicare Advantage plans as well as hospital care that may affect your costs and benefits.

More Free Care Means Better Health and Wellness

A great deal of preventive care is now available to you for free. This type of health care will help you maintain wellness and evade diseases. Keep in mind that if you have a Medicare Advantage plan, the free health care that is available to you may vary from one plan to the next.

If you have original Medicare you will be able to get a wellness exam each year at no cost to you. Your doctor will work with you to develop a plan to keep you in good health.

Most screenings will be available to you for free in order to detect certain illnesses early, when they will be easier to treat. For example, you will be able to get a mammogram to screen for breast cancer, colonoscopy for colon cancer as well as tests for high cholesterol, high blood pressure and diabetes.

In addition, smokers can also get help kicking the habit. You will have free counseling available to you to help you quit smoking and prevent serious illness.

Save Money on Prescription Drugs

The “donut hole” is becoming smaller. If you need to take a large number of prescription medications, you are most likely well aware of what is referred to as the “donut hole”. If you are new to Medicare and not familiar with the term, the “donut hole” is the gap in prescription drug coverage under Medicare Part D.

As it stands now, up to $2,970 is covered by the Part D plan each year for prescription drugs. This includes both what you pay – as well as what is paid for by your insurance. Once that threshold is passed, your benefits will begin to decline and you will be in the “donut hole”.

While you are in that “donut hole”, your co-pay for your prescription drugs will go up to 79% for generic medication and 47.5% for brand name drugs. You will pay this percentage until you spend $4,750 on your medications.

Eventually, the “donut hole” will disappear. Every year from now until the year 2020, the percentage that you have to pay while you are in the “donut hole” will continue to decrease. By 2020, the “donut hole” will be gone completely and you will only pay 25% for all of your prescription drugs, regardless of whether you by generic or brand name medicines.

Medicare Advantage Plans

Pay close attention if you have a Medicare Advantage plan, which is also referred to as Medicare Part C, because you may see some changes in your coverage. Some of these changes will be for the better, while others will be for the worst.

The Affordable Care Act says an insurance company will receive a bonus for the improvement of your Part C plan. However, this means that Medicare will pay less for some Medicare Advantage plans. Therefore, some Medicare Advantage plans may see a reduction in benefits, such as dental care. In addition, you may see an increase in the amount that you pay for co-payments. Even if no benefits are cut by the Affordable Care Act directly, you may lose some of them as insurance companies make changes in coverage.

Same Rules Apply for High Incomes

If your income is less than $85,000 as an individual or $170,000 for a couple, you will be paying $104.90 a month for Medicare Part B. This will also include the Part D prescription drug coverage. This will affect 95% of those that use Medicare in the Dunkirk, Fredonia, Silver Creek, and Chautauqua County region.

If your income is greater, then the cost of your Medicare coverage will increase. This will affect about 5% of those who are on Medicare.

If you are in the higher income group, the amount that you have to pay will depend on your income. For example, if your annual individual income is $85,000 to $107,000 a year or $170,000 to $214,000 for couples, you will have to pay an additional $42 for Part B and $11.60 every month for Part D. The higher your income, the more that you will have to pay for your Medicare benefits.

At Putnam Record Insurance Agency, we have invested the time to learn the details of the changes in Medical Insurance. We are currently running several in-person Medicare and Personal Health Insurance workshops in Dunkirk, Fredonia, Silver Creek, Chautauqua County regions, where you can attend an open meeting with your friends and neighbors, and learn what you need to be aware of, all while being in a no-obligation pressure free environment.

If you are interested in these local informational workshops, simply fill in the form at the top of this page with your name and email address, and we will give you more details. Thank you.

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