Saturday, September 21, 2013

In New Health Law, a Bridge to Medicare

Published: September 9, 2013

THE sweeping federal health care law making its major public debut next month was meant for people like Juanita Stonebraker, 63, from Oakland, Md., who retired from her job in a hospital billing office a year and a half ago.

She was able to continue her health insurance coverage from the hospital for a time, but when she tried to find an individual policy on her own, none of the insurers she contacted would cover her because she was diabetic.

“I didn’t even get to tell them about the heart attack,” said Ms. Stonebraker, who has been without health insurance since July. She is a little over a year away from qualifying for Medicare, the federal insurance program for people 65 and older. She now worries a recent hospitalization will leave her several thousand dollars in debt.

Under the Affordable Care Act, or Obamacare, insurers must now offer coverage to people like Ms. Stonebraker, and they will not be able to set the premiums they charge on the basis of someone’s health. Starting Oct. 1, she and millions of other Americans are expected to be able to buy one of the plans available through newly created online state marketplaces, or exchanges, for coverage that begins in 2014. For those with low incomes, subsidies are available to help pay premiums.


Early retirees are “the big group of winners in this equation,” said Edward A. Kaplan, a senior benefits consultant at the Segal Company, who said many of the premiums he had seen so far in the states that had made them public were relatively low, with subsidies making them even lower.


As for next year, experts say retirees who already have Medicare should see no surprises as a result of the law. Those eligible can still opt for traditional Medicare, along with a drug-only plan, or one of the Medicare Advantage plans run by private insurers, but they do not have to select their plans through the new exchanges.

“Medicare has not been radically altered,” said Gerry Smolka, a policy expert at AARP Public Policy Institute. “This is the same for you as it was last year.”


Nine million Americans between 50 and 64 years old were uninsured in 2010, according to a recent analysis by the AARP Public Policy Institute.

Greg Burke, for example, is 61 and he retired in 2008. While he still had insurance from his former employer, he had a knee replacement.

“After my knee replacement, I found that the insurers didn’t love me anymore,” Mr. Burke said.


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