Whether you’re approaching age 65 or already enrolled in Medicare, the annual enrollment period for 2011’s Medicare plans is an important time. When it comes to prescription coverage, seniors are seeing some of the biggest changes since the Medicare prescription benefit became available in 2006.
The changes – from having fewer options to premium increases to new discounts on brand-name drugs – are enough to make anyone’s head spin. But, seniors who don’t take the time to research their options and choose the plan that best suits their needs could leave hundreds of dollars in annual premium savings on the table.
In fact, according to a recent study by the Robert Wood Johnson Foundation, only about 10 percent of participants change plans annually. Staying put and not investigating your options, however, could impact your overall costs. But how do you know if you have the best plan already or if you should consider a different plan? Luckily, there are a few tools that can help with the decision-making process. But first, let’s start with the basics and what is changing this year.
Access to private plans
Beneficiaries have access to the Medicare drug benefit, known as Part D, through private plans approved by the federal government, either through stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PDs). According to a Kaiser Family Foundation study in October 2010, of those who purchase Part D coverage, 38 percent, or 17.7 million beneficiaries, opt for stand-alone plans. Twenty-four percent, or 11.1 million, are enrolled in Medicare Advantage plans.
Plan options in 2011
While shopping around could save many seniors money, some beneficiaries have no option other than to find a new plan for next year. For 2011, the federal government directed insurers to eliminate duplicative Part D prescription drug plans and plans with low enrollment. That means a third fewer prescription drug plans will be offered nationwide next year compared to 2010, according to the Kaiser Family Foundation, and many of the remaining options may come with higher premiums.
And with the federal government changing the way it reimburses health plans through Medicare Advantage, some insurers have quit offering their Medicare Advantage plans for next year. If your plan is no longer being offered, you may need to find alternative coverage.
Beneficiaries have a six-week annual enrollment period – from Nov. 15 to Dec. 31 – to pick a Part D plan for 2011. For Medicare Advantage enrollees, it is especially important to pick the right plan during that period. Unlike previous years, people enrolled in Medicare Advantage plans can no longer switch to other Medicare Advantage plans during January, February and March. However, while this “open enrollment period” will not be available in 2011, after Jan. 1, enrollees can still leave their Advant...
Medicare supplement plans or Medigap insurance is the private health insurance plans that are for those people who already have a Medicare policy. The Medigap insurance or Medicare supplement plans helps the Medicare beneficiaries to bear that extra medical cost that are left aside by the original plans. The name Medigap is suggested because it is believed that these policies bridges the gap between the Medicare coverage and the original expenses or the total bill charged. However in the recent studies it is seen that in the United States about 18% of the people having original Medicare policy goes for the supplement plans also.
Now you have to know the benefits of this plan. There is an eligibility criterion, which you have to obey. Most of these criteria fixed by most of the insurance companies are the same. To go for a Medigap health insurance plan a person is required to be enrolled in part A and B of original Medicare before they can go for a Medigap health insurance plan. A person may obtain a Medigap plan on a guaranteed issue basis during the open enrollment period, which begins within 6 months of turning 65 or enrolling in Medicare Part B at 65 or older. And also that I this period no medical screening is required.
But besides open enrollment the issuing insurance company may also put forth the requirement of medical screening and also may obtain an attending physicians statement if it is felt necessary. But the thing that should be kept in mind is that this policy is not compatible with any other forms of private medical coverage as for example a Medicare Advantage plan.
Let us start from part A. Part A Medigap health insurance plan is your hospital insurance. It helps you to pay for the medical treatment that you receive in a hospital or skilled nursing facility. It also covers some of your home health care and hospice care, if you are ill for a time being.
Part B is that part of the insurance coverage that helps you pay for the medical services that are not covered by the Part A policy. It also includes the Doctor’s charge. It is rather helpful when you are having a Part A policy.
Part C is that part of the insurance coverage or such a Medicare health insurance plan that combines both Part A and B coverage. It also provides some additional services. The Part C Medicare supplement plan is offered only through Medicare approved private insurance companies.
The Part D Medicare supplement health insurance plan is for your prescr...
Are you caring for an aging, disabled or seriously ill friend or family member? If so, you’re one of more than 44 million people who serve in the important – and often unrecognized — role of a caregiver.
For many caregivers, a typical day can involve everything from answering questions about Medicare claims and prescription drugs, to preparing meals and running errands, to searching for the best long-term care or in-home services. Whether you’ve been providing care for a long period of time, or anticipate that you’ll be acting as a caregiver in the near future, it’s important that you find resources that provide the support and answers you need.
Created by the Center for Medicare & Medicaid Services (CMS), the Ask Medicare initiative offers numerous resources to make your life easier. Accessed online at www.medicare.gov/caregivers, Ask Medicare provides tips and helpful resources on enrolling in Medicare, coping with a chronic illness, comparing drug plans and long-term care options and more. You can find answers to commonly asked billing questions and utilize an interactive tool that will help you determine which services Medicare covers. In addition, the site offers access to a free e-newsletter with the latest updates from Medicare and a video series providing useful tips on managing transitions in care, such as being discharged from the hospital or moving into a long-term care facility.
The Ask Medicare Web site also links t...