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What Physicians Should Know About Benefits for Seniors

Posted by Drew Hudson March 22, 2011 at 12:15 PM

As part of our series of Anniversary week webinars for the Patient Protection and Affordable Care Act, Joe Baker, President of the Medicare Rights Center, gave a 15 minute presentation and answered questions about the benefits of the ACA for seniors.  Dr. Jeff Huebner, a family physician practicing in Madison, WI and a member of the NPA Policy Committee also answered questions during this hour.

You may view a recording of the webinar below, and if you still have questions about seniors and the ACA you may leave a comment below and Joe will respond in the next few days.

10 Responses to “What Physicians Should Know About Benefits for Seniors”

  1. Bill Jordan says:

    Will the free preventive care also include mental health screenings?

    • Medicare Rights Center says:

      Mental health screenings are not a preventive benefit that is covered with no copay or deductible. However, screenings for cognitive issues are included in the annual wellness visit. You can find out more about how Medicare covers mental health care by visiting Medicare Interactive here: http://www.medicareinteractive.org/page2.php?topic=counselor&page=script&slide_id=923

      • Jeff Huebner says:

        Taking a look at our answer from the Medicare Rights Center (they certainly are more the policy experts here than me), I would interpret the link provided as an answer to the question of a specific outpatient visit where the patient is coming in exclusively for mental health care services. I still think most good primary care professionals would provide mental health screening as part of the annual wellness physical that is now covered. And this is the beauty of that visit now being covered. In the past when patients came in with a list of three or four problems (or more) and you suspected depression for example as well, it would be difficult to ever include mental health care and screening – now you can tell your patients to come back for full physicals that would include a discussion of physical and mental health/wellness

    • Jeff Huebner says:

      Yes the free preventive care will include mental health screenings in that the annual Medicare physical where prevention is discussed will provide a good opportunity for depression or other mental health screenings, as well as cognitive screenings.

  2. Bill Jordan says:

    Will the elimination of annual caps on benefits also apply to mental health coverage?

    • Jeff Huebner says:

      My understanding is that the elimination of annual caps on coverage also does apply to mental health coverage, not just in Medicare but in all health plans that fall under PPACA provisions. Unfortunately there are some exceptions to this e.g., “self-insured” plans do not fit under this provision and there are some others. But overall mental health coverage parity will greatly improve under PPACA.

  3. Medicare Rights Center says:

    Most outpatient mental health care is covered by Medicare with a 45% coinsurance. This means that Medicare pays 55% and an individual or their supplemental insurance will be responsible for the remaining 45%. By 2014 mental health services will be covered the same way most outpatient services are covered, with the traditional 80%-20% cost sharing between Medicare and people with Medicare respectively.

  4. Jeff Huebner says:

    Some of you may be wondering, what preventive services, exactly will be covered and how was this determined? As a practicing physician, I think this is one of the best coverage provisions within the Affordable Care Act (ACA) for our patients.

    Here’s a brief overview:
    The ACA specified that beginning 1/1/11, all Medicare-covered preventive services with a Grade A or B rating for clinical evidence, as determined by the U.S. Preventive Services Task Force must be fully covered by Medicare with no cost sharing for the patient. You can see the complete list at: http://www.medicare.gov/navigation/manage-your-health/preventive-services/preventive-service-overview.aspx. I think a lot of my patients will no longer put off cancer screenings or immunizations due to cost.

  5. […] March 22 – Benefits for Seniors with Joe Baker, President of the Medicare Rights Center This webinar has been completed, a recording is now available to view and  join the discussion – click here […]

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