Issue link: https://www.epageflip.net/i/174579
Thursday, September 19, 2013 – Daily News 5B Health care overhaul confuses Medicare beneficiaries By Kelli Kennedy Associated Press MIAMI -Dear seniors, your Medicare benefits aren't changing under the Affordable Care Act. That's the message federal health officials are trying to get out to elderly consumers confused by overlapping enrollment periods for Medicare and so-called "Obamacare." Medicare beneficiaries don't have to do anything differently and will continue to go to Medicare.gov to sign up for plans. But advocates say many have been confused by a massive media blitz directing consumers to new online insurance exchanges set up as part of the federal health law. Many of the same insurance companies are offering coverage for Medicare and the exchanges. Medicare open enrollment starts Oct. 15 and closes Dec. 7, while enrollment for the new state exchanges for people 65 and under launches Oct. 1 and runs through March. "Most seniors are not at all informed. Most seniors worry they're going to lose their health coverage because of the law," said Dr. Chris Lillis, a primary care physician in Fredericksburg, Virginia. "I try to speak truth from the exam room but I think sometimes fear dominates." Next month, roughly 50 million Medicare beneficiaries will get a handbook in the mail with a prominent Q&A that stresses Medicare benefits aren't changing. Federal health officials have also updated their training for Medicare counselors, and are prepping their Medicare call center and website. "We want to reassure Medicare beneficiaries that they are already covered, their benefits aren't changing, and the marketplace doesn't require them to do anything different," said Julie Bataille, spokeswoman for the Centers for Medicare and Medicaid Services. But she said call centers for the state exchanges are already fielding questions from Medicare recipients and rerouting them to the Medicare line. Bob Roza attended several meetings trying to figure out exactly what the Affordable Care Act means for him and his 69year-old wife Gail, who has diabetes. "At that time, I didn't know if Medicare would be secondary to some Affordable Care Act option. It was just a myriad of concerns and not knowing," said the 72year-old Roza, a retiree who lives in Oakdale, Calif., and is recovering from hip replacement surgery earlier this year. He now knows that his Medicare coverage won't change, but says he's now worried about the impact on the $614 a month he pays for Medicare supplemental insurance. Federal health officials said seniors will not be able to purchase Medicare supplemental insurance or Part D drug plans through the state exchanges. Jodi Reid, executive director of the California Alliance for Retired Americans, worries there hasn't been enough outreach to seniors and that advocacy groups are spending the bulk of their advertising funds targeting those impacted by the exchange. Her organization, which represents nearly 1 million seniors in California, is putting together a one-page fact sheet to help dispel myths. "Nothing has been done that I have seen to deal with the 4.4 million people in California who are on Medicare who are not going to be impacted the same way as the rest of us so it's causing a lot of confusion," she said. AARP officials said they anticipate a spike in calls after the October launch date for the new state exchanges. To help clarify everything for seniors, the organization is holding various events around the country, such as a senior day next month at the state fair in Columbia, S.C. Next month, the group is also hosting 21 telephone town halls, which will include hundreds of thousands of phone calls to seniors. "Usually the marketing is just targeted to the Medicare beneficiary, this time it's going to be spread out a little bit more. If they call the wrong places, we're doing our very best to make sure they're guided back to the correct place," said Nicole Duritz, vice president of health education. In Illinois, it's not only seniors who are confused, but also the social workers who help them, said Erin Weir of AgeOptions, suburban Cook County's lead agency on aging. The agency coordinates a statewide training program for groups that work with older adults. During these trainings, Weir said, she's repeatedly heard questions from social workers who think seniors will be able to sign up for Medicare programs on the new marketplace websites, even though they cannot. "We've been focusing on people who are already on Medicare, calming them down and saying, 'You don't have to do anything, you're fine,'" Weir said. Advocates are also warning of scams that may pop up alongside legitimate door-to-door outreach about the Affordable Care Act ramps up and advising seniors not to give out personal information. Senior groups are also devoting resources to educating the 50- to 65-yearold group who are next in line for Medicare, a segment that could be greatly affected by the health reform. Under the new law, insurers will have to offer more benefits in some cases and are restricted in how much they can charge older, sicker people. They're also banned from turning away those with pre-existing conditions. Anthony Wright, executive director of Health Access California, said many people nearing retirement age stand to benefit the most by the health care reform. "They're the ones most likely to have pre-existing conditions, most likely to be charged more because of their age and medical condition and very likely to be an early retiree," he said. Associated Press writer Carla K. Johnson in Chicago contributed to this report. Walgreen moves health coverage to private exchange By TOM MURPHY AP Business Writer Walgreen Co. is joining a growing push from big businesses to shift more responsibility for finding insurance onto their employees as health care costs continue to climb. The nation's largest drugstore chain said Wednesday that it will send workers to a private health insurance exchange where they will pick from as many as 25 plans instead of having the company give them two to four options. Employers normally pay most of the coverage cost, and Walgreen's contribution toward the benefit won't change. It said the move will give its workers more choices and help them become better consumers. ''I think the only way to drive down costs in the health care space is to have the consumer buying the health care be knowledgeable and educated and understand what they are buying, '' said Tom Sondergeld, senior director of health and wellbeing for the Deerfield, Ill., company. Employers have struggled for years with health care costs that climb faster than inflation and consume growing portions of their budgets. More are starting to veer from the decades-old practice of offering workers only a plan or two with benefits the employee might not want. The alternative, called defined contribution health insurance, involves giving employees a set amount of money and then letting them pick their own coverage through a private marketplace or exchange that helps them sort out the choices. The switch can make the employer's health care costs more predictable or give them a way to reduce the amount they spend per employee. Proponents of the approach say it also forces employees to pay more attention to the cost of their coverage, and that will make insurers compete more on price. But it also means workers who are used to having their coverage chosen for them could wind up with big medical bills and inadequate coverage if they don't pick wisely. The exchanges are similar to the public exchanges or marketplaces that will debut next month for coverage that starts in 2014 as part of the health care overhaul, the massive federal law that aims to cover millions of uninsured people. Sears Holdings Corp. and Darden Restaurants Inc., which operates the Red Lobster and Olive Garden chains, are among the companies that have already shifted to this approach with a private exchange run by benefits consultant Aon Hewitt. Walgreen runs more than 8,100 drugstores nationwide and provides health coverage for about 180,000 employees and dependents. It also will use Aon Hewitt's exchange for coverage that starts next year. Aon Hewitt expects enrollment in its exchange business to triple to more than 600,000 people for coverage that starts next year. The consultant said it has 18 companies, each with more than 5,000 employees, lined up for 2014. Employees using the Aon Hewitt exchange answer between 10 and 15 questions to figure out which plan may work best for them. One of the questions asks whether the employee could handle a $1,500 medical bill. That helps determine whether a high-deductible plan would work for the employee. Those plans are cheaper than traditional coverage but require the employee to pay more upfront for care before most coverage begins. The process of picking coverage is more complex than other consumer decisions like making trip plans on a travel website ''It's a little bit more involved than buying a plane ticket, but I don't think it's more involved than buying a TV,'' said Ken Sperling, Aon Hewitt's national health exchange strategy leader. The employer's contribution to coverage purchased on these exchanges may wind up covering a greater or smaller portion of the insurance bill than the worker is accustomed. It depends on the plan selected. Workers who use these exchanges also can wind up paying a bigger share of the insurance bill over time if the contribution from their company doesn't climb to keep up with insurance costs or the worker doesn't chose a cheaper plan. Sondergeld, the Walgreen executive, said his company will consider adjusting its contribution in the future if needed. Employer-sponsored coverage is the most common form of health insurance in the United States, covering more than 149 million non-elderly people. Benefits experts say defined contribution plans make up a relatively small slice of that total, but the trend is expected to grow, especially with big companies. A total of 29 percent of firms with 5,000 or more employees surveyed earlier this year by the nonprofit Kaiser Family Foundation said they are considering offering benefits through a private exchange. In contrast, only 7 percent of companies with 200 to 999 workers are considering it. The consulting firm Accenture projects that private health insurance exchanges will become bigger than the overhaul's public version by 2018. It expects about 40 million people to be enrolled in coverage through a private exchange that year, compared to 31 million enrolled through the public version. That's a big leap from next year, when Accenture expects private exchange enrollment, counting workers and retirees not yet eligible for Medicare, to total 1 million. Health benefits trends tend to grow slowly. Many companies prefer to wait to see how other companies fare after making a big switch before they try it on their own employees. But benefits experts say more companies are starting to appreciate the stability defined contribution plans offer. The approach means a company that pays its employee medical bills isn't on the hook for an unexpected expense if a wave of big claims hits during the year. 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