The Affordable Care Act (ACA) will undoubtedly reduce seniors’ access to care. The cuts to the Medicare Advantage program can affect the well-being of seniors across the country.

1. http://www.outsourcestrategies.com/ 1-800-670-2809
Affordable Care Act – How It
Will Impact Seniors?
The Medicare Advantage (MA) program has
grown in popularity –
especially among seniors. By
focusing on prevention and
disease management, MA
plans help to improve
enrollee health outcomes
and contain costs. Seniors
who are enrolled in Medicare are in compliance
with the Affordable Care Act (ACA) and
wouldn’t need to replace their coverage with a
new plan. They will still have the same benefits
and securities already provided.
Changes That Will Impact Medicare
Beneficiaries
• Prescription drug costs: The first change
is the reduction of the cost of prescription
drugs; this change was
motivated by the
“doughnut hole.” It
refers to the Medicare
Part D coverage gap.
Part D provides the
much-needed prescription drug coverage

2. http://www.outsourcestrategies.com/ 1-800-670-2809
for seniors at costs far lower than
estimated, is highly popular with seniors,
and is costing taxpayers much less than
originally estimated.
Medicare beneficiaries will have to pay for
their prescription medications out of pocket
once the beneficiary and a Medicare Part D
provider has spent a certain amount of
dollars on prescription drugs; in 2014 this
amount is $2850. A person who has paid
$4450 out of pocket for covered drugs
including the amount spent prior to
entering the doughnut hole, enters
catastrophic coverage. In this position, a 5
% co-insurance or co-pay of $2.25 for
covered generic drugs and $6.35 for
covered brand-name drugs have to be
paid. Since 2010, more than 7.3 million
seniors and people with disabilities entered
the doughnut hole. The ACA aims at
closing the “doughnut hole” by 2020.
• Preventive services costs: A second goal
of the ACA is to reduce or eliminate the
cost of preventive services for all people
with health insurance, including Medicare
beneficiaries. Each Medicare beneficiary is
eligible for an annual wellness exam, as

3. http://www.outsourcestrategies.com/ 1-800-670-2809
well as cancer screenings, immunizations,
diet counseling, etc.
• Medicare fraud, waste, and abuse
prevention: A final change provided by
the ACA with regard to Medicare is
reducing fraud, waste, and abuse. The law
provides $350 million over 10 years to
enhance anti-fraud efforts. According to
the Health Care Fraud and Abuse Control
Program Annual Report for Fiscal Year
2013 published in February 2014 by HHS,
the U.S. recovered $4 billion last year
through healthcare fraud prevention and
enforcement efforts. The report says that
the Health Care Fraud and Abuse Control
Act (HCFAC) recovered more than $8 for
every $1 it spent on healthcare fraud
investigations over the last three years.
Since medical billing mistakes are so
common, almost everyone will fall victim to
these errors at some point in their lifetime.
Fraudulent medical billing practices may
include - submitting claims for services not
provided, falsifying claims or medical
records and misrepresenting dates,
frequency, duration or description of
services rendered.

4. http://www.outsourcestrategies.com/ 1-800-670-2809
With the Medicare Cuts, Seniors Are
Losing Doctors
The recent report is that The Affordable Care
Act (ACA) will have a negative impact on
seniors. A portion of ACA funding is derived by
cutting $716 billion from the Medicare program
over the next decade - which could reduce
seniors' access to care. One provision includes
around 24 percent fee reduction for physicians
who treat Medicare enrollees. Another
provision - the Independent Payment Advisory
Board - will have the power to reduce Medicare
spending even if it adversely impacts the
providers who treat Medicare enrollees.
With the lack of availability of doctors as a
result of the increase in Medicare cuts from the
Obama administration, seniors are left with the
choice of keeping the same insurance plan and
find another doctor or paying out of pocket or
look for another plan where their physician is a
member.