Along with the Fall and Winter holiday season, Medicare open enrollment is a certainty for many seniors. As a Medicare recipient, you have a chance each year to make changes to your Medicare Advantage plan or Medicare prescription drug coverage for the following year.
Since plan costs and coverage change each year, you should check to make sure that your plan still meets your needs and budget. Your Medicare Advantage plan may no longer be available where you live or there may be a health or drug plan available with better coverage or a lower deductible in 2011.
Some Dates to Remember
- Watch your mail for notices from Medicare, Social Security, and your current health and drug plans with information about changes in 2011
- Compare plans online at www.medicare.gov starting October 15
- “Medicare & You” 2011 arrives in your mail
- Open Enrollment starts November 15
- Open Enrollment ends December 31
During this time you should:
- Review the 2011 costs and coverage of your current plans. For example, how much more will your premiums and out-of-pocket costs (such as annual deductible and copayments) increase? Are all your medications still covered on your prescription plan’s drug formulary?
- Compare your current plans with other plans being offered in your area.
- Choose a plan that meets your health needs and budget. With so many options available, choosing the plans that are best for you is important.
Changes You Can Make During Open Enrollment
During the Medicare open enrollment period (11/15/2010 – 12/31/2010), you can make the following changes in your coverage:
- Change from Original Medicare to a Medicare Advantage Plan.
- Change from a Medicare Advantage Plan back to Original Medicare.
- Switch from one Medicare Advantage Plan to another Medicare Advantage Plan.
- Switch from a Medicare Advantage Plan that does not offer prescription drug coverage to another Medicare Advantage Plan that offers drug coverage.
- Switch from a Medicare Advantage Plan that offers prescription drug coverage to another Medicare Advantage Plan that does not offer drug coverage.
- Join a Medicare Prescription Drug Plan.
- Switch from one Medicare Prescription Drug Plan to another Medicare Prescription Drug Plan.
- Drop your Medicare Prescription Drug coverage completely.
Choosing and Enrolling in a New Plan – Step by Step
Review your current health and prescription drug plans. The costs for your current plans most likely will change so you need to know your current benefits and costs.
Compare your existing Medicare plans with other ones in your area to see if you can find a better choice. If you want to keep the existing plans, you do not have to do anything. Your plans will automatically rollover at the end of the open enrollment period (12/31/2010).
Go to www.Medicare.gov to compare plans. You also will receive a list of plans in your area in the back section of Medicare and You 2011.
If you chose new plans, you may be able to join using one of the following methods:
- Sign Up with a paper Medicare Application – the health insurance company that manages the plan you have selected will have an application. You can fill it out and send it back by mail, fax or possibly email.
- Visit the plan’s website – the site will provide instructions how to apply. You may be able to print out an application or provide the necessary information online.
- Check the Medicare Website – all, or most of the plans in your area are listed on the Medicare website. You may be able to apply on the Medicare site or link to the plan’s website.
- Phone the health insurance directly and request an application. Many plans will enroll you be phone.
- Many plans have enrollment meetings in the communities they serve. These may be at a local senior center or other location. During these meetings you can get additional information, ask questions, and enroll.
Where to Get Help
If you are confused about which plan to choose or need help enrolling, there are several organizations that can assist you:
- Your local community senior center may have volunteers who can provide appropriate advice and even sit with you to help you complete an application.
- The SHIP network in your state provides one-on-one assistance, community education session, and an answer hotline to help Medicare beneficiaries. You can locate your state’s SHIP program or find a counselor on the SHIPtalk website.
- You can call Medicare at 1-800-Medicare (1-800-633-4227) for assistance.
Changes to Medicare in 2011
The Affordable Care Act has made changes to the Medicare program, several of which are effective in 2011. These include:
- Cost-sharing expenses (deductibles, copayments, and coinsurance) for preventive services such as glaucoma tests, mammograms, and prostate cancer screening will be eliminated.
- Medicare will pay for an annual checkup, including a physical examination and access to a comprehensive health risk assessment and creation of a personalized prevention plan.
- If you reach the donut hole, you will be given a 50% discount on the total cost of brand name drugs while in the gap.
- If you are enrolled in an Advantage plan, you may have increased premiums. However, across the country these plans will cost an average of one percent less than they did in 2010.
- Medicare Advantage Fee-for-Service Plans will no longer be offered – you will be able to switch to a managed care Advantage Plan or back to original Medicare.
Some Tips from Dr. Mike
If you decide to make a change to your Medicare plans, it is important to do so as soon as possible. This will help you avoid any confusion at your doctor’s office or local pharmacy when the new plans go into effect in January.
Make sure to keep a record of any correspondence or phone conversations you have had with customer service representatives at the plans you’ve chosen.
If you have not received confirmation that you are enrolled in your plan of choice, call the plan immediately.
And, most important, if you are not sure what to do get some help.