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Today, the Department of Health and Human Services (HHS) issued a memo clarifying that all beneficiaries in private Medicare plans have access to equal coverage when it comes to care in a nursing home where their spouse lives. This is the first guidance issued by HHS in response to the recent Supreme Court ruling, which held section 3 of the Defense of Marriage Act unconstitutional.
“HHS is working swiftly to implement the Supreme Court’s decision and maximize federal recognition of same-sex spouses in HHS programs,” said HHS Secretary Kathleen Sebelius. “Today’s announcement is the first of many steps that we will be taking over the coming months to clarify the effects of the Supreme Court’s decision and to ensure that gay and lesbian married couples are treated equally under the law.”
“Today, Medicare is ensuring that all beneficiaries will have equal access to coverage in a nursing home where their spouse lives, regardless of their sexual orientation,” said Centers for Medicare & Medicaid Services (CMS) Administrator Marilyn Tavenner. “Prior to this, a beneficiary in a same-sex marriage enrolled in a Medicare Advantage plan did not have equal access to such coverage and, as a result, could have faced time away from his or her spouse or higher costs because of the way that marriage was defined for this purpose.”
Under current law, Medicare beneficiaries enrolled in a Medicare Advantage plan are entitled to care in, among certain other skilled nursing facilities (SNFs), the SNF where their spouse resides (assuming that they have met the conditions for SNF coverage in the first place, and the SNF has agreed to the payment amounts and other terms that apply to a plan network SNF). Seniors with Medicare Advantage previously may have faced the choice of receiving coverage in a nursing home away from their same-sex spouse, or dis-enrolling from the Medicare Advantage plan which would have meant paying more out-of-pocket for care in the same nursing home as their same-sex spouse.
Today’s guidance clarifies that this guarantee of coverage applies equally to all married couples. The guidance specifically clarifies that this guarantee of coverage applies equally to couples who are in a legally recognized same-sex marriage, regardless of where they live.
Watch the Obamacare videos & get the facts
Obamacare is making health care work better for all of us, even if you already have insurance. It puts the health of your family first—ensuring access to free preventive care and protecting consumers from insurance company abuses.
|71 Million Kids & Adults With Private Insurance Have Received No-Cost Preventive Care.
“HHS estimates that, as a result of the ACA, 71 million children and adults with private insurance, and 34 million Medicare beneficiaries have received no-cost preventive care. Enhanced federal matching funds in Medicaid are available to states providing all USPSTF-recommended preventive benefits without cost-sharing, but, to date, few states have made the changes required to gain the higher match rate.” “Health Reform-The Affordable Care Act Three Years Post-Enactment,” Kaiser Family Foundation, March 2013.
|Discrimination By Insurance Companies For Children With Pre-Existing Conditions Was Banned.
“Coverage exclusions for children with pre-existing conditions were prohibited as of September 23, 2010. Insurers are no longer permitted to deny coverage to children due to their health status, or exclude coverage for pre-existing conditions. Protections for adults will take effect in 2014. In addition, lifetime limits on coverage in private insurance have been eliminated and annual limits are being phased out.” “Health Reform-The Affordable Care Act Three Years Post-Enactment,” Kaiser Family Foundation, March 2013.
|Consumers Received $1.1 Billion in Rebates From Their Insurance Companies.
“Insurance companies that don’t spend at least 80 percent of its customers’ premium dollars on health care are required to provide rebates to policy holders. In 2012, the first year this rule was implemented, 12.8 million consumers received $1.1 billion in rebates.” “Health Reform in Action,” WhiteHouse.gov, accessed 6/5/13.
|3.1 Million More Young Adults Have Health Insurance Through Their Parent’s Plan.
“Under the law, most young adults who can’t get coverage through their jobs can stay on their parents’ plans until age 26.” “Health Reform in Action,” WhiteHouse.gov, accessed 6/5/13.
|Seniors Have Saved More Than $6.1 Billion on Their Prescription Drugs Since 2010.
“Seniors who hit the gap in Medicare’s prescription drug coverage, often called the ‘donut hole’ now receive 50 percent discounts on covered brand name drugs. The new health reform law will provide additional savings each year until the coverage gap is closed in 2020.” “Health Reform in Action,” WhiteHouse.gov, accessed 6/5/13.
Much has been said over the past few weeks about the budget proposal in the House of Representatives, offered by Rep. Paul Ryan, and backed by Republican members, but not much has been said about how it will affect our veterans. As you know, the Paul Ryan plan will end Medicare, making it a voucher program, leaving seniors to buy their own insurance in the private system. It will therefore end one of the most popular and successful initiatives ever offered.
This plan will also punish veterans – harshly – and it’s important that you spread the word on how it will do so.
Here are the facts:
- Millions of veterans over 65 rely on Medicare, Medicaid or private insurance for their health care. In fact, according to the last survey of veterans by the Department of Veterans’ affairs, 39.3% of veterans use Medicare, compared with 14 percent of the general population.
- Many of these veterans are relying on Medicare as their sole health care provider. The Ryan plan would have an immediate impact on these veterans, forcing those falling into the “donut hole” with high-cost prescription drug costs to pay more for their medications in addition to paying more for preventative health services.
- Veterans who rely on Medicaid would not escape cuts either. The Republican plan could slash $1.4 trillion in health benefits over the next ten years. Forty-four states are already facing significant budget shortfall in Fiscal Year 2012,and the cuts could force the state to either ration health care benefits for veterans across the country, restrict eligibility rules and leave thousands uninsured, including veterans, or raise taxes to cover the shortfall.
- Finally, many veterans rely on private insurance, mostly through their employer. Because Republicans want to repeal the recent health insurance law, these veterans will no longer have guaranteed access to health insurance regardless of pre-existing conditions and may see annual or lifetime caps on coverage under the Republican budget.
In short, Republicans and Paul Ryan will strip away care for our veterans, in the name of budget cutting. These proposals are draconian, cruel, and unfair to those men and women who put their lives on the line for this country. But, unless we spread the word about how severely the Ryan/Republican plan will hurt veterans, most Americans won’t ever know.
Take some time to read their propaganda and get to know what they’re trying to do. Be an informed voter, not someone who swallowed their propaganda, hook, line and anchor.
|GOP 2012 Platform||GOP Growth Opportunities||2009 Road to Recovery||2010-Better Solutions|
|2010-Pledge to America||P2P v1.0||P2P v2.0||P2P v3.0|
Read/compare a few to see what you think — and if you’d like you can compare the actual budget numbers between plans here.