How the ACA Will Affect Medicare


By Amy Blitchok Google

There is no denying that understanding Medicare can be a difficult task.  With different plans that cover various services, it can take a lot of digging around just to figure out how much coverage you are eligible for and whether or not you can receive reimbursement for the cost or mobility and disability equipment.  As the Affordable Healthcare Act continues to roll out over the next months, more and more seniors are wondering how the ACA with affect or further complicate their Medicare coverage.  Read on to get answers to all your important questions.


Medicare and Durable Medical Equipment

Unfortunately, Medicare will only cover the cost of mobility equipment for a small fraction of people.  There are strict standards about what is covered and any eligible piece of equipment must meet all of the following standards: 

  • Durable (long-lasting)
  • Used for a medical reason
  • Not usually useful to someone who isn’t sick or injured
  • Must be prescribed by a doctor
  • Used in your home 
Preventing Medicare Fraud
Under the new healthcare law, your prescription may also have to be reviewed by a Medicare auditor.  This extra step is not meant to make receiving equipment more difficult, but to prevent rampant cases of fraud.  In the past, patients, doctors, and entire companies have made millions by making fraudulent claims.  Under the ACA, the same eligibility requirements apply, but an extra layer of oversight has been implemented that will hopefully save millions.  Some reports claim that in 2012 alone, the ACA was able to save taxpayers $4.2 billion through the prosecutions of fraud cases. 
Prescription Drug Coverage
The ACA was also designed to cover a gap in Medicare’s prescription drug coverage that became known as the “donut hole.” This gap in coverage required left some Medicare recipients paying 100% of their drug costs until they reached a certain number of total spending.  Under the new law, that gap has been closed seniors will receive some percentage of coverage for all of their medications. *To get specific details regarding prescription drug coverage visit this informational site.  
Besides additional fraud protection and improvements to prescription plan coverage, seniors should not experience any other changes to their Medicare benefits due to the ACA.  Hopefully, the ACA will actually improve senior health by providing free testing and encouraging preventative care.  
If you have more questions about whether you qualify to have Medicare help cover the cost of your durable medical equipment, feel free to contact an AmeriGlide expert