The Affordable Care Act, Medicaid And Medicare

Tamra K. Waltemath

Tamra K. Waltemath

For those people who are covered by Medicare or Medicaid, there is no need to go online to enroll in the Affordable Care Act (ACA). Your coverage under Medicare and Medicaid will remain the same with some improvement. The ACA is not replacing Medicare or Medicaid. A 100 page guide was sent to 52 million Medicare beneficiaries containing information on their coverage which can be found at Nothing will stop a Medicare beneficiary from signing up for a ACA plan, but if you do you will be double insured and you will not qualify for premium tax credits or subsidies offered to low-income applicants.

There are many misconceptions about how the ACA will affect with Medicare. Some information has indicated that Medicare beneficiaries will pay more for their medications under the ACA, but this is not true. The Part D premium will increase slightly for Medicare beneficiaries with higher incomes (individuals with annual incomes over $85,000.00 or couples with annual incomes over $170,000.00), but the cost of prescriptions will not increase, actually the majority of Medicare beneficiaries have started paying less for their prescriptions. See the recent newsletter of the Medicare Rights Center at, September 19, 2013. Medicare beneficiaries may continue to see their own doctors and there are many incentives to encourage doctors to enter into the ACA program so there may be more doctors who will take Medicare patients.

I am hopeful that the ACA will improve the health of my senior clients. The most beneficial provision of the ACA is the elimination of coverage denial for pre-existing conditions. People need not hesitate to go to their doctor for treatment of a pre-existing condition because it will not be covered by their insurance. In addition, the ACA covers yearly wellness visits and screenings for many types of cancers and other illnesses. Studies have shown that testing for colon cancer, breast cancer and many other conditions leads to early treatment and often a cure.

There will be some disadvantages of the ACA, especially for those who are transitioning from Medicaid to Medicare. Medicaid provides full coverage for all health care costs. Medicare requires premium payments and co-pays (out of pocket costs). There will also be timing issues to ensure that coverage does not lapse and to avoid Medicare penalties resulting from delayed enrollment, but there will be far more people transitioning from Medicare to Medicaid as a result of the ACA.

This article was written by Tamra K Waltemath of Tamra K. Waltemath, P.C. This information is for general informational purposes only and does not constitute legal advice. For specific questions, you should consult a qualified attorney. Tamra K. Waltemath is an elder law attorney focusing on wills, trusts, estate and trust administration, probate and non-probate transfers, guardianships and conservatorships. She can be contacted at: Tamra K. Waltemath, P.C., 3843 West 73rd Avenue, Westminster, CO 80030; 303-657-0360; or visit her website at:

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