Affordable Care Act: The Benefits of Caring for the Elderly

Affordable Care Act: The Benefits of Caring for the Elderly

The Patient Protection and Affordable Care Act (ACA) has significantly contributed to improving care delivery for the elderly throughout the country, primarily through the extension and modification of insurance plans. of health. Among the many changes, improving the efficiency and effectiveness of Medicare reduced monthly Medicare Part B premiums. In 2013, the premium was lower than the predictions of analysts: only $104.96; and stood at $104.97 in 2014. It is amazing in and of itself. But the ACA did much more than keep the cost of Part B down; This also reduces costs and improves the efficiency of Medicare Part C; the “Medicare Advantage” program, which allows private insurance companies to integrate the current Medicare benefits at lower than normal costs.

Medicare Part C

For most seniors, Medicare Part C is the only viable alternative to Medicare Parts A and B, which allows private Cheap Health Insurance 2020 companies to accept Medicare money to pay for some of the adult premiums. As payments are shared between the government and the citizen, the latter can pay for insurance that would otherwise not be available, which for the majority of older adults means insurance that actually guarantees most of insurance costs. medical care “. Under the law, Part C plans always provided at least the same insurance as Medicare A and B, but have been at the root of some of the most ingenious developments in the area of ​​personal care for the elderly, including case management. and coordination of care. Almost 30% of all beneficiaries of Medicare use Medicare Part C.

How ACA has improved an excellent system.

The big “challenge” Medicare Part C was the difference between the amount of private insurance paid to a provider for a particular service through Part C and the amount paid by the A/B parties for the same service. Disbursements have varied greatly with some plans that pay less than the maximum, but the majority overspend for the same service, penalizing the “standard” Medicare beneficiaries in the eyes of the medical institution.

For example, the ACA enacted provisions that cover Part C payments to insurance companies within the 5% limit of “standard Medicare” payments based on “reasonable and customary” fees for each service in the geographic area where the service was provided. They also called for Medicare Part C plans to be sold with the same traditional insurance grants, allowing seniors to compare Medicare Advantage plans and determine which are the most convenient and offer the best insurance. The impact of this change is that insurance companies benefit a little less from each of the C participants who provide services, in part 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 show up at ACA health clinics. The net effect is beneficial to insurers: while profit per participant decreased by approximately 10%, the number of recipients increased by 33%, so the end result increases each year.