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Tx4obama

(36,974 posts)
3. Here's an excerpt from an article about Sebelius, ACA, and Medicare - AND a FAQ PDF
Wed Oct 30, 2013, 10:56 PM
Oct 2013


See this one here first...




AND below is a from an article on Politifact.com

-snip-

Employer insurance vs. Medicare

We went right to the source on this one, asking the Department of Health and Human Services if Sebelius misspoke. It turns out she did.

Individuals who have health insurance through their employer can sign up for the online marketplaces, it’s just not financially beneficial for most to do so. If an individual forgoes affordable insurance through work, he or she won’t qualify for subsidies to help pay for insurance on the government-run marketplaces. And plans purchased through an employer are typically cheaper because the company is paying a portion of the costs.

A spokeswoman for the department said Sebelius meant to say, "Marketplace plans cannot be sold to a Medicare enrollee, and the secretary is a Medicare enrollee."

While Sebelius receives health benefits from her government job, as of May, she is also 65 years old and therefore eligible for free Medicare Part A, which covers hospital visits. She can couple those benefits with her employer insurance, but according to guidelines released Oct. 4 by the Center for Medicare & Medicaid Services, "it is illegal to knowingly sell or issue a Qualified Health Plan to a Medicare beneficiary" on the government-run insurance marketplaces.

That hasn’t always been clear, said David Lipschutz, a policy attorney at the Center for Medicare Advocacy. Nothing in the Affordable Care Act mentions whether Medicare enrollees are eligible for the health insurance marketplaces, he said, but the administration lately has cited a section of the Social Security Act also known as the Medicare Anti-Duplication provision that bars private insurance companies from offering coverage to Medicare enrollees.

There are some exceptions. A small fraction of individuals who are not eligible for free Medicare Part A and those with end stage renal disease can still buy insurance on the exchanges and receive federal subsidies. Neither of those situations apply to Sebelius.

Hypothetically, Sebelius could abandon her government health care plan and get out of Medicare Part A. But that would require her to revoke and forfeit her Social Security benefits for the rest of her life, something we can’t envision anyone volunteering to do.

"It’s really not going to be an option to drop it in order to get into an exchange," said Andrea Callow, also a policy attorney with the Center for Medicare Advocacy.

-snip-

http://www.politifact.com/truth-o-meter/statements/2013/oct/30/kathleen-sebelius/sebelius-says-she-not-eligible-exchange-because-i-/




Hope that helps

My assumption would be that having Medicare would make you uneligible to partcipate tritsofme Oct 2013 #1
See comment #3 Tx4obama Oct 2013 #7
I am a salaried MD in a low income clinic Chuuku Davis Oct 2013 #2
i don't, but my friend just got medicare DesertFlower Oct 2013 #5
Are you suggesting that a doc that is 'forced' to take medicare patients elleng Oct 2013 #26
Would a doctor risk leftynyc Oct 2013 #49
No, you're not... (nt) Jeff In Milwaukee Oct 2013 #59
Here's an excerpt from an article about Sebelius, ACA, and Medicare - AND a FAQ PDF Tx4obama Oct 2013 #3
So iow, poor seniors are screwed. Nothing for them. As far as I know from helping two elderly sabrina 1 Oct 2013 #23
medicare part B is $105 for 2013. DesertFlower Oct 2013 #25
My Daughter Has A Masters Degree As An ARNP... ChiciB1 Oct 2013 #43
i live in phoenix, arizona. DesertFlower Oct 2013 #63
That's The Question That Needs Answering! ChiciB1 Oct 2013 #65
exactly. obama couldn't even get DesertFlower Oct 2013 #68
My Income Isn't All That Much... ChiciB1 Nov 2013 #69
happy to hear your son turned his life DesertFlower Nov 2013 #70
I only have parts A and B for which I pay $105 per month. RebelOne Oct 2013 #50
Apply for Medicaid Sgent Oct 2013 #66
I didn't know about this until I was in the hospital and almost dead earlier this year, but... Systematic Chaos Oct 2013 #32
Helpful post! B Calm Oct 2013 #39
We were helping to take care of two elderly relatives over the past couple of years sabrina 1 Oct 2013 #40
thank you for the link. DesertFlower Oct 2013 #64
"Low poor " seniors are eligible for Medicaid, pnwmom Oct 2013 #35
This was already in place, then. It's not part of the ACA? sabrina 1 Oct 2013 #41
This has been in place for decades -- not part of ACA. n/t pnwmom Oct 2013 #58
You're leaving out dual-eligibility for Medicaid Recursion Oct 2013 #37
Well, I knew about Medicaid being available for the poor. What people have sabrina 1 Oct 2013 #42
are you on DU advocating that seniors leave Medicare for a private health insurance plan? CreekDog Oct 2013 #46
I received an answer to my question, thank you, except for one sabrina 1 Oct 2013 #62
"Docs who don't take Medicare"- I wonder if that will babylonsister Oct 2013 #4
i've heard it's too much paperwork. DesertFlower Oct 2013 #8
They don't feel that get paid enough through Medicare. Few take Medicaid. Hoyt Oct 2013 #10
coding and billing is basically the same -just the payout rate has been going down for Medicare lunasun Oct 2013 #12
my friend's rheumatologist said she take DesertFlower Oct 2013 #9
Medicare has been paying out less and less to drs, in benefits over lasr 5 years lunasun Oct 2013 #11
I could be wrong but I dont think there are many doctors that run their own show anymore indie9197 Oct 2013 #15
I work with independent private drs. and yes it is becoming harder and harder to stay out of hospita lunasun Oct 2013 #17
here's an example from the medicare sight DesertFlower Oct 2013 #16
i just looked up the doctor payment for last year DesertFlower Oct 2013 #20
for a 15 minute appointment? CreekDog Oct 2013 #47
yes. although he spends more DesertFlower Oct 2013 #60
My Doctor Downsized From 3 Office Personnel To 1... ChiciB1 Oct 2013 #44
If you receive or are eligible for Medicare, no. The Velveteen Ocelot Oct 2013 #6
On Medicare myself, having heard various things, I went to the Medicare website, enough Oct 2013 #13
Gee a doctor is not getting paid enough with Medicare Lifelong Dem Oct 2013 #14
see #16. i've given a breakdown of DesertFlower Oct 2013 #18
Thar is why doctors are opting out they cant pay overhead and everyone who should be concerned lunasun Oct 2013 #19
That's a big reason single payer has such resistance: medical providers would make much less money Recursion Oct 2013 #38
Support that Sgent Oct 2013 #67
I've notice lots of Dr's in my area banding together... Historic NY Oct 2013 #21
Here: Raine1967 Oct 2013 #22
Why would ANY doctor take Medicare patients if it only pays for kestrel91316 Oct 2013 #24
same with my grandparents, but not for 20 years. DesertFlower Oct 2013 #27
Part A is for hospitalization, Part B is for doctor services, ect. tritsofme Oct 2013 #28
exactly. nt DesertFlower Oct 2013 #29
My income is low enough that what Medicare doesn't cover, Medicaid does. Kaleva Oct 2013 #31
Well if Medicare stopped paying for life-extending multimillion dollar procedures kestrel91316 Oct 2013 #51
It doesn't only pay for hospital care. Where are you getting that? pnwmom Oct 2013 #34
It is. I'm not close to Medicare age yet so I don't know this stuff. kestrel91316 Oct 2013 #52
whoa, whoa, hang on there...the thing you are so upset about is fiction CreekDog Oct 2013 #48
I didn't realize about Part A and Part B. Though now that I do, I am completely baffled as to why kestrel91316 Oct 2013 #53
So Medicare's a conspiracy now? Wow. Well, that's wrong. CreekDog Oct 2013 #54
Huh? I thnk maybe you have gotten confused about something i said or confused me with somebody else. kestrel91316 Oct 2013 #56
WTF? You think Medicare doesn't cover hip replacements? CreekDog Oct 2013 #57
Wait, what? When did I say Medicare was a scheme to enrich doctors and hospitals???? kestrel91316 Oct 2013 #61
I agree..once again I keep sayin: gopiscrap Oct 2013 #30
I m 72 years old and I am on Medicare chillfactor Oct 2013 #33
that's a medicare advantage plan DesertFlower Oct 2013 #36
In Ky some social security recipients are eligible for adult medicaid Puzzledtraveller Oct 2013 #45
My husband fought (and lost) his battle spartan61 Oct 2013 #55
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