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Did the Affordable Care Act change Medicare?

Who is this for?

Learn more about how Medicare works.

Whether you're learning about Medicare or already enrolled, this page will help you understand how health care reform affects your coverage.

The Affordable Care Act changed a lot about the way health insurance works. You might be concerned these changes mean you’ll have to pay more or do things differently to get your Medicare coverage.

For the most part, that’s not the case. You’ll keep the benefits that you’re used to with your Medicare plan. And many of the changes are aimed at keeping you healthier and helping you save on out-of-pocket costs.

How Medicare hasn't changed

Generally, enrolling in a Medicare plan will be the same.

  • Medicare isn’t offered through the Health Insurance Marketplace. So you won’t have to visit healthcare.gov to sign up for your coverage.
  • The Open Enrollment Period for Medicare plans is the same. You can sign up for Medicare Advantage, Medigap or Part D prescription drug plans between Oct. 15 and Dec. 7 every year.

How Medicare has changed

There are a few differences in the coverage you’ll receive with your Medicare plan.

Most Americans are now required to have health insurance. For many Medicare members, nothing will change. But there are a few situations where someone may have to enroll in additional coverage to meet the law’s requirements.

If you have an Original Medicare or Medicare Advantage plan, you’re already considered covered according to the Affordable Care Act. If you only have Medicare Part B, you’ll need to get a Medicare Part A plan or pay a tax penalty.

There are a few other changes you can expect to see with your Medicare coverage:

  • Some preventive services, like cancer screenings and yearly wellness checks, are now covered at no cost.
  • If you have Part D prescription drug coverage, you pay 45 percent of the cost for brand-name drugs when you reach the “donut hole," or coverage gap. Each year, you'll pay less for drugs in the coverage gap. The government wants to completely eliminate it by 2020. 

If you still have questions about how the Affordable Care Act affects your Medicare coverage, use these additional resources for more help.