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Medicare choices come early this year

Medicare's open-enrollment period started this month. Select the plan that's right for you in 2012.

By MSN Money Partner Oct 24, 2011 4:41PM

This post comes from Giselle Smith at MSN Money.

 

If you've been using Medicare for several years and are accustomed to having through the end of the year to choose your plan for the following year, be aware that open enrollment for Medicare started a month early this year -- on Oct. 15 -- and extends only through Dec. 7.

 

The earlier timetable was set so that patients would have new membership cards in hand -- and paperwork would be completed -- by Jan. 1, when plan changes take effect, according to NPR.

 

During this time you can choose between Medicare and Medicare Advantage, and you can sign up for drug coverage under one of the Part D options.

 

Even if you are satisfied with your current coverage, it's a good idea to review your options to make sure your current plan is still available for 2012. If you decide you want to stick with what you have, however, you don't need to do anything else to remain enrolled.

 

Making changes after Dec. 7 could cost you a late-enrollment penalty, but if you are turning 65 in 2012, different rules apply

 

Other changes in Medicare

Of course, a new open-enrollment period is just one change for 2012. Others will be seen in premiums, which are going up for higher-income beneficiaries, and the "doughnut hole," which is shrinking.

 

As Consumer Reports (.pdf file) notes:

Some seniors, especially those who take multiple or very expensive medications, have been caught in the "doughnut hole," meaning they reached a coverage gap and had to pay drug bills from their own pockets until they became eligible for catastrophic coverage. Now half the cost of brand-name drugs in the doughnut hole is covered, and by 2020 the hole will be closed and there will be no gap in drug coverage.

Another change is that six of the top plans in the Medicare Part D market are raising premiums, as reported by Fox Business: "The drug plan unit of one large player, UnitedHealth Group, is raising 2012 premiums an average of 14%."

 

One more change for 2012 is more emphasis on a five-star-rating system Medicare uses to rate plans based on how well they perform in different categories, including member complaints, staying healthy (for Advantage plans), and drug pricing (for Part D plans). Higher ratings mean bonuses for health plans, whose overall ratings have increased about one-quarter of a star to an average of 3.44 stars for 2012, according to NPR. And Medicare officials expect ratings to increase again next year.

 

During a "special election period" -- from Dec. 8, 2011, until November 2012 -- participants can opt to switch to a Medicare Advantage or Part D plan that has a five-star quality rating. Post continues after video.

Choosing the right plan

The best course of action, according to Nancy Metcalf of Consumer Reports, is to carefully consider your options:

Has your current plan changed? Are your doctors and drugs still on its list? Try to estimate how the premium (if any) and your projected out-of pocket health care expenses compare with the cost of original Medicare plus a Medigap plan and a Part D plan.

Some other things to consider:

  • If you are considering a Medicare Advantage plan, are your doctors and providers covered under the plan? Talk to your doctors and ask if they recommend it.
  • Medicare Advantage plans often offer additional benefits not covered by Medicare Parts A and B. Does the one you are considering offer dental, vision or hearing care?
  • Total all of your drug costs, including premiums, deductibles, co-pays and out-of-pocket expenses, and note any name-brand drugs you are taking, as costs for these more expensive drugs vary widely by plan.
  • When signing up for drug coverage under a Part D plan, check the formulary to make sure your prescriptions are covered -- and then reverify that your drugs are covered, warns Lita Epstein, author of "The Pocket Idiot's Guide to Medicare Part D," on Fox Business. "Sometimes there are mistakes on the site, and changing your plan later isn't easy."

Here are some additional resources that can help you learn more:

  • Visit the Medicare website, or call Medicare at (800) 633-4227.
  • Use the Medicare Plan Finder, an interactive tool that takes you through your options step by step. 
  • Check out the Medicare Rights Center, a nonprofit consumer service organization that helps Medicare recipients understand their benefits and navigate the system.
  • Read AARP's Guide to Medicare.

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