Medicare’s Annual Enrollment period has been moved up
“This is the time of year when people who are eligible for Medicare, generally age 65 plus, can enroll in or make changes to their Medicare Advantage plan,” said Westphal. This year there is a change in the timing of the enrollment period and it is important to be aware. The 2011 enrollment period runs from October 15 to December 7 — a month earlier than previous years. During this period, members can join a Medicare Advantage plan, change plans, and add or drop their Part D prescription drug coverage.
What a Medicare Advantage plan is
A Medicare Advantage plan is a Medicare health plan choice provided by a private company that is contracted with Medicare. These plans include both Part A and Part B coverage, and sometimes Part D Prescription Drug coverage, in one plan. Medicare Advantage plans fill in the gaps in Medicare alone, including prescription drug coverage, routine annual physicals, worldwide coverage for urgent and emergent care, alternative care, and routine eye exams. Original Medicare only pays for 80 percent of Medicare approved charges after a member pays for their annual deductible, and then the member is responsible to pay the rest.
“This could add up to a significant amount of money,” said Westphal, “so Medicare Advantage plans are designed to alleviate that financial burden.”
The difference between Medicare Advantage and Medicare Supplement plans
Medicare Supplement plans (also known as Medigap plans) are standard plans (A-N) offered by private companies. There are no discernable differences in the plans offered between private companies. With Medicare Supplement plans, Medicare is billed first and pays their share of the bill up to Medicare approved amounts. Then the Medicare Supplement plan is billed and pays its part of the bill. Members can only see providers that accept Medicare. Premiums are based on age and increase as members get older.
Medicare Advantage plans are offered by private companies contracted with Medicare to cover both Part A, Part B, and sometimes Part D coverage in one plan. These plans are not supplement plans. The providers members can see vary by plan (HMO, PPO, POS) and there are a variety of plan designs. Healthcare providers bill the Medicare Advantage plans – not Medicare - for all covered services. The Medicare Advantage plan pays both Medicare’s share of the bill as well as any other services covered by the Medicare Advantage plan that are not covered by Original Medicare. Premiums are not based on age; everyone on the plan pays the same premium.
“With a Medicare Advantage plan, you and your doctors deal with a private company, rather than with Medicare directly,” said Westphal. “Medicare Advantage plans also take a more active role in managing the money so your Medicare dollars can stretch further.”
How to choose a Medicare Advantage or Medicare Supplement Plan
Westphal advises people to look at all expenses you'll be paying, not just premiums.
“Deductibles, coinsurance, copayments, and out-of-pocket maximums may vary greatly from plan to plan,” said Westphal. “When shopping for a plan, consider what the monthly premium is and what out-of-pocket expenses you could expect to pay with each plan, and find the combination that works best for you.”
He said it is also a good idea to check if your doctors and hospitals are in your plan’s provider network, and to find what coverage you will have outside the plan’s service area, especially if you like to travel, winter in a warmer climate, or pay extended visits to your adult children.
When plans will release information about their 2012 plans and premiums
All Medicare Advantage plans will be allowed to release their 2012 plans and rates on October 1, said Westphal. “On October 1, consumers will find 2012 plan information on health plan’s websites and on www.Medicare.gov.”