Readers ask about ‘minimal essential coverage,’ Social Security numbers on cards, other issues


A lot of the attention focused on the Affordable Care Act has gone to how the law affects private insurance.

But our readers have plenty of questions about the act and how it works with the public-insurance programs Medicare, for seniors, and Medicaid, for the working poor.

We’ll jump right in:

■ Mark Paul wonders if his Medicare plan qualifies as “minimal essential coverage” to avoid federal penalties for not having a policy.

Yep, Mark, you’re good. Medicare does indeed count as full coverage, and you don’t need to lift a finger to change your situation.

That won’t necessarily stop scammers from preying on worried seniors, though. The state Division of Insurance and Nevada Attorney General Catherine Cortez Masto have both warned seniors that con artists posing as “navigators” who sign up people for insurance could try to scare the already-covered into coughing up personal information, including bank account details and Social Security numbers.

Look out in particular for people who call you to say they have your new “Obamacare” or Medicare insurance card, which they’ll send your way if you just hand over your credit card number. You don’t need a new Medicare card, so ignore those pitches, and toss any unsolicited mail or email from someone trying to sell you coverage. You truly don’t need it. And if someone asks you for payment up front for anything, it’s a huge red flag.

If you suspect someone is trying to defraud you, call the Division of Insurance at 486-4009 and report the person immediately.

That’s not to say the Affordable Care Act leaves Medicare untouched. If you have a Medicare Advantage plan to help cover costs Medicare doesn’t pay, your policy could change. Medicare will pay less to some Medicare Advantage plans, but it’s hard to say which will see the biggest differences. Some plans will cut dental care, while others might boost your out-of-pocket co-pays.

On the other hand, some insurers get bonuses if they upgrade their Medicare Advantage plans.

Here’s where you can help us sort out what’s going on: If you’re on Medicare Advantage and your plan has changed for better or for worse, let us know how. We might share your comments in a future story.

■ Speaking of Social Security numbers and Medicare: Georgia Sallows says she’s concerned that Medicare puts her Social Security number on her insurance card. She wants to know if there’s a better way to identify insured patients.

AARP is with you, Georgia. The seniors’ advocacy group has called for new forms of Medicare identification, and federal lawmakers have written bills that would create a different system, such as Medicare “smart cards” without Social Security numbers printed on them. Even the Social Security Administration and the Federal Trade Commission have asked lawmakers to find a new way.

The problem, Medicare officials told Congress in 2012, is that it would take nearly $1 billion and five years to issue new numbers and cards for current enrollees.

There’s hope, though: Some federal health systems, including Veterans Affairs, are using identification digits different from Social Security numbers.

While we wait to see if Medicare goes the same route, Georgia, AARP recommends you make a copy of your Medicare card, cut it to wallet size and snip out the last four digits of your number. Just remember to take the original card on your first visit to a new doc, so the billing department can copy it for their files.

■ Sandra, who didn’t want us to disclose her last name, writes: I would like to find out the best website/resources as to how one qualifies for Obamacare’s Medicaid.

You’re looking for the state Health and Human Services Department, Sandra. That’s the agency tasked with tracking eligibility and signing up Medicaid enrollees.

By “Obamacare’s Medicaid,” we assume you mean the expanded version that the Affordable Care Act created. Nevada is one of 30 states participating in expanded Medicaid.

The new rules boost the income limit from 87 percent of the federal poverty wage pre-Obamacare to 138 percent after. So the annual income cutoff jumped from $10,000 to about $15,800 if you’re a single, childless adult. And that’s new, too: Nevada’s Medicaid program wasn’t previously open to childless adults.

If you have a family of four, your maximum allowed income has gone from $20,500 to $32,500.

Those numbers may increase a bit in 2014, as the poverty wage is adjusted upward.

State officials estimated early on that 78,000 poor Nevadans would be newly eligible for Medicaid. That’s 13 percent of the state’s 600,000 uninsured. But because enrollment began only on Jan. 1, it’s hard to estimate how many have signed up via expansion. Health and Human Services Director Mike Willden said on Jan. 9 that sign-ups in December surged to 38,000, or more than three times their normal monthly rate, but that came from already-eligible Nevadans joining the program to comply with the federal coverage mandate.

The federal government said it will cover the full cost of new enrollments through 2016. After that, Washington will pay “no less than 90 percent of the costs in the future,” according to the Centers for Medicare &Medicaid Services.

To apply for Medicaid online, visit dwss.nv.gov, and click on the big, rectangular box that says, “Access Nevada.” If you don’t want to share your personal information with an impersonal electronic box, you can get eligibility details by calling 1-800-992-0900. Two agencies, the Access to Healthcare Network (www.accesstohealthcare.org) and Nevada Health Centers (www.nevadahealthcenters.org), can help you enroll as well.

■ Anita Toso has this related question: Is an adult under the age of 65 who is unemployed in Nevada eligible to obtain insurance under the Affordable Care Act?

If you’re not working, Anita, you’re almost certainly eligible for expanded Medicaid. The average Nevadan on unemployment benefits takes in a hair over $15,000 a year, according to an August press release from the state Employment, Training and Rehabilitation Department. That average would put you about $800 below the new, higher Medicaid income limit.

The most any Nevadan on unemployment can take in annually is about $21,200. If you’re at that level, you might not qualify for Medicaid, but you should be able to get an advanced premium tax credit if you buy a plan through the Silver State Health Insurance Exchange.

There’s no requirement that you be employed to buy; just pay your share of your premiums, and your coverage will stay in full effect whether you’re working or not.

Next week: Readers had lots to say about Jan. 19’s piece on a federal single-payer proposal. We’ll share some feedback.

Contact reporter Jennifer Robison at jrobison@reviewjournal.com. Follow @J_Robison1 on Twitter.

 

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