Call it the health-insurance version of an October Surprise.
This year, the annual Medicare fall open-enrollment period, during which seniors eligible for Medicare can choose or alter their coverage plans, will overlap with the launch of the health-insurance marketplaces mandated under the Affordable Care Act, also known as Obamacare.
Finding the right Medicaid plan, figuring out deductibles and worrying about the prescription drug "donut hole" can be confusing enough, particularly for seniors entering the venerable healthcare system for the first time. But given the government shutdown and the ongoing controversy over President Barack Obama's plan for health care reform – and the scary ads aired during the extended wrangling over federal spending – it's not surprising there's widespread uncertainty.
"The overlapping enrollment period is already causing some confusion" among Medicare recipients, says Paula Muschler, operations manager for Allsup, a private company that advises seniors on their health-care options. "With all the resurgence of interest in health care exchange, they are asking, 'How does this affect me?'"
The answer: not much. What follows are some FAQs about Obamacare's relationship with Medicare, and what seniors should consider during the open-enrollment period:
Q: Will Obamacare change my Medicare?
A: Your Medicare is still protected, it will be for the foreseeable future, and the Affordable Care Act doesn't negatively change it.
Medicare isn't part of the state-by-state health insurance marketplaces the ACA establishes, so seniors don't need to shop or replace the Medicare coverage they have now. Your Medicare counts as coverage so your benefits and security will stay the same.
"That's important for people to understand," said Juliette Cubanski, a Medicare policy analyst at the nonprofit Kaiser Family Foundation. Seniors "don't need to worry about the mandates, they don't need to worry about penalties" for not having health insurance.
Q: So you're saying that Obamacare won't change Medicare at all?
A: Not exactly – you'll get a few more services, and save more money.
Because of the ACA, Medicare now covers certain cancer early-detection screening services, like mammograms or colonoscopies, with no out-of-pocket charges and without charging you for the Part B coinsurance.
"There are changes made that are actually improvements in benefits," Cubanski said. "That's something for people to actually look forward to."
Seniors now qualify for a free yearly "wellness" visit to a doctor, and health care reform is slowly closing the Medicare prescription drug coverage gap. More on that later.
Q: What's the open-enrollment period?
A: The Medicare open-enrollment period, which runs from Oct. 15 through Dec. 7, is the window for 50 million Medicare recipients to review, tailor or change their policies.
Some Medicare plans during the past year may have been altered or premiums may have risen or fallen, according to Muschler. Seniors already enrolled in a Medicaid plan can review their policies, adjust them or enroll in new health plans that better suit their needs – and the sooner, the better.
"Don't put it aside, don't think your plan isn't changing," she said. "It might be small changes but they may be changes you need to pay attention to. Seniors need to act now, don't delay it.
Even if their current Medicare coverage plan is satisfactory, Muschler and others recommend reviewing it anyway to make sure it hasn't been reworked significantly since last year. A simple switch to a competing plan can save thousands in out-of-pocket costs, including prescription drug co-payments.
Q: I turn 65 in a few months – I'll be eligible for Medicare but I haven't enrolled yet. What should I do during the Open Enrollment period?
A: Seniors who will become Medicare-eligible soon have a different deadline.