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Culver resident and insurance agent Don Kline -- whose wife Janet introduced him noting he's been in the business for 45 years and has currently around 1,000 clients -- stopped by Culver's weekly Kiwanis Club meeting last Thursday to help his audience navigate how the Affordable Care Act will affect senior insurance costs in the near future.
Kline began by pointing out the legislation, popularly known as "Obamacare," will affect those under 65 far more than seniors, but will indirectly affect everyone on Medicare due in part to reduced funding for Medicare.
Those seniors on Medicare Advantage plans should know government funding towards those plans, which is currently around $700 per month, will be cut, which has already led to some premiums "sneaking up" within Advantage plans.
Those 65 and older, or disabled, and on Medicare have two choices, Kline explained. One is to have Part A and B Medicare in addition to the purchase of a drug plan and Medicare supplement. The latter will run between $80 and $140 per month, with the drug plan at $30 to $40 per month.
Most healthy seniors, however, go with Medicare Advantage plans, whose premiums "have been very affordable," he said.
Kline cited a client who, at age 85, has been paying $385 per month, and is living on $1,100 per month total.
"I took her out of Medicare and put her into an Advantage plan, and she next year will now pay $17 a month."
With Advantage plans, he added, the customer has a co-pay for each doctor visit, and drugs are usually included.
However, Kline said those with drug prescriptions will likely see change. He referenced a local druggist who said a bottle of 500 tablets currently costing the druggist $200 will likely go up to $500 or as much as $800 starting next year. The result is an increase in co-pays and retail prices of drugs.
The government, said Kline, has a model drug plan with a $310 deductible. Once the retail price of drugs reaches $2,850 total within a given year, "you're in the gap or donut hole. You pay a percentage until your out of pocket costs run up to $4,500. I have some people in the February or March."
Kline did point out those on Medicare are eligible to participate in no-cost preventative services and screenings, including blood and lab work.
"We thank the taxpayers for supporting us seniors," he said.
Asked for his general take on Obamacare, Kline said some parts of the legislation are "lousy," but praised some developments, such as adult dependents being able to take advantage of their parents' insurance while living with parents, and an end to denying coverage to children with diseases such as leukemia due to pre-existing conditions.
"But we're trying to pay for 33 million people without health insurance," he added. "We're just taxing the businesses."
He also said in many cases part time employees are being taken off group insurance plans in the workplace to compensate, and dependents such as spouses are being disallowed from work-based plans. However, those dependents may be able to shop around for better rates as a result.
Kline also pointed out, in contrast to some discussion as to whether or not the Affordable Care Act has passed, that the legislation is already law, though the implementation date keeps moving back. He also noted some 10,000 federal employees will be added in order to administrate it.
"It's socialism here we come," he said. "That's what it is."
Also clarified was the status of HMO plans.
"If you see advertisements for zero (cost) Medicare Advantage plans, they're probably HMOs, and they don't work in Marshall County...you have to be very careful (regarding HMOs) in rural areas."
Thanks to Trent Bennett for assisting with this article.