Florida Elder Law Blog - A blog by Elder Law Associates, South Florida's premier elder law attorneys, who handle elder law, medicaid planning, guardianships and much, much more.
This
year's holiday shopping season has begun early for Medicare
beneficiaries: the program's Open Enrollment Period, during which you
can enroll in or switch plans, began October 15 and ends on
December 7.
During this period, you
may enroll in a Medicare Part D (prescription drug) plan or, if you
currently have a plan, you may change plans. In addition, during the
seven-week period you can return to traditional Medicare (Parts A and B)
from a Medicare Advantage (Part C, managed care) plan, enroll in a
Medicare Advantage plan, or change Advantage plans. Beneficiaries can go
to
www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227) to make changes in their Medicare prescription drug and health plan coverage.
Even
beneficiaries who were satisfied with their plan in 2011 need to review
their options for 2012, particularly because things are still in flux
due to changes brought on by the health care law. Prescription drug
plans can change their premiums, deductibles, the list of drugs they
cover, and their plan rules for covered drugs, exceptions and appeals.
Medicare Advantage plans can change their benefit package and as well as
their provider network.
According
to the federal Centers for Medicare and Medicaid Services (CMS),
Medicare Advantage premiums are expected to decrease by an average of 4
percent next year from this year, while Part D plan premiums will likely
increase about 2 percent to $30 a month, on average.
"There's no doubt that a lot of seniors are in the wrong plan," Ross Blair, the CEO of
PlanPrescriber.com, a site that compares Medicare plans, told
SmartMoney. "A lot of them could save hundreds of dollars a year by switching."
Reaching for the Stars
One change beneficiaries using the
Medicare Plan Finder will notice this year is CMS's
enhanced five-star rating system.
Plans that have achieved a five-star rating from CMS are identified
with a "gold star" icon. Those that have received a low overall quality
rating for the past three years are identified with a "warning signal"
icon. Another new innovation is that there is no time limit to switch
into a five-star Advantage or prescription drug plan. Medicare
beneficiaries have one opportunity to switch to one of these top-rated
plans anytime during 2012. (For more on the significance of the star
rating system, see
"Medicare Plans See Dollars in the Stars.")
If you want out of your
Advantage plan after December 7, you can "disenroll" between January 1
and February 14. At that point you can return to traditional Medicare
and add a Part D plan, or move into a five-star Advantage plan. But if
you return to traditional Medicare you may not be able to buy Medigap
coverage at that point, although the rules vary by state.
If you take no action,
you will remain in your current plan unless your Medicare Advantage or
drug plan is terminating its Medicare contract. Also, if you receive the
Low-Income Subsidy (LIS) to help pay for some or most of your Part D
drug costs, you may be randomly reassigned to a different plan. (For
more on the LIS program, also known as "Extra Help,"
click here.)
Some factors to consider when evaluating your drug plan include:
- What is the monthly premium?
- Does the plan continue to cover necessary drugs?
- Does the plan provide coverage for drugs in the "doughnut hole" or coverage gap?
- What pharmacies are covered under the plan?
Some factors to consider when comparing Medicare Advantage plans include:
- What is the monthly premium?
- What is the cost-sharing for doctor visits?
- Which doctors and hospitals are covered?
- Is prescription drug coverage included?
- Are any other extra benefits included and will they be useful to you?
(For a MarketWatch article on picking an Advantage plan,
click here.)
Remember
that fraud perpetrators will inevitably use the Open Enrollment Period
to try to gain access to individuals' personal financial information.
Medicare beneficiaries should never give their personal information out
to anyone making unsolicited phone calls selling Medicare-related
products or services or showing up on their doorstep uninvited. If you
think you've been a victim of fraud or identity theft, contact Medicare.
For more information on Medicare fraud, click
here.
Here are more resources for navigating the Open Enrollment Period:
For more about Medicare,
click here.
As always, before making any final legal decisions, please contact a qualified
South Florida Elder Law Attorney who is also an experience
South Florida Medicaid Planning Attorney.
Labels: Elder Law Attorney, Florida Elder Care, florida elder law, Florida Elder Law Attorney, Florida Medicaid Planning, Florida Medicare Planning, Medicaid Planning, Medicare
