Review Your Health & Drug Coverage Options Carefully, Medicare Beneficiaries ToldEditor's Choice
Main Category: Medicare / Medicaid / SCHIP
Article Date: 15 Oct 2011 - 7:00 PDT
Review Your Health & Drug Coverage Options Carefully, Medicare Beneficiaries Told
|Patient / Public:|
The Medicare Rights Center, a national, nonprofit consumer service organization, advises that everyone enrolled in a private health or drug plan with Medicare should review their cover during the upcoming Fall Open Enrollment Period. This includes those who are currently satisfied with their plan as providers change their benefit packages on a yearly basis.
Unlike previous years, this year's Fall Open Enrollment Period takes place from October 15 through December 7, during which period Medicare beneficiaries have the opportunity to change their health and drug cover options without restriction by making as many changes as necessary. The last opportunity for changes is on or before December 7, for the changes to become effective by January 1, 2012.
Joe Baker, president of the Medicare Rights Center explained:
"Medicare beneficiaries need to be aware of the date change this year, and carefully review all of their options in time to make a decision by December 7.
While reviewing your options, you may be attracted to low-cost drug plans or Medicare Advantage plans, but it is very important to read the fine print. Depending on your health status and the plan's rules and restrictions, you may discover that the low-cost plan will actually cost you more than a plan with a higher premium."
People who have a Medicare Advantage plan, also known as a Medicare private health plan, or Medicare drug plan should have received their Annual Notice of Change (ANOC) by September 30. Information on changes in the plan, such as premiums and co-pays can be found in The ANOC, which offers a comparison of benefits in 2012 and 2011.
As usual, for clarification purposes, similar plans from the same company have been consolidated and may now be offered under a different name, however, the ANOC will also provide information on name changes as a result of consolidations.
Those, who own cover that has been consolidated will automatically be enrolled in a plan from the same company with the most similar benefits to their previous plan, with the free option to choose a different cover. Comparisons of 'old' and 'new' cover options are provided in their ANOC.
The Medicare Rights Center urges people to consider various questions before enrolling in a Medicare Advantage plan. For a full list of questions which policy is best suited for each individual, please visit Medicare Interactive.
Medicare clients who become unsatisfied with the Medicare Advantage plan they chose have the opportunity to change to Original Medicare and a stand-alone prescription drug plan during the Medicare Advantage Disenrollment Period (MADP), which starts January 1 and ends February 14. They are also entitled to add a Part D prescription drug plan during the MADP, however, they cannot switch from one Medicare Advantage plan to another. Owners of Original Medicare policies cannot make changes during the MADP.
As of 2012 Medicare beneficiaries will have a Special Enrollment Period (SEP) to enroll in a Medicare Advantage or Part D plan with a five-star rating (on a scale of one to five). Beneficiaries may take advantage of the SEP once a year at any time for one change. Multiple changes are not possible. More information about the new SEP can be found on page 3 of Fall Open Enrollment Period: A Resource for Journalists (PDF).
According to Baker:
"The new right to enroll in a five-star plan once at any time during the year shouldn't make beneficiaries complacent about choosing a plan during Fall Open Enrollment.
We recommend putting the time in now to review your options, ask questions, and choose the plan that is the best fit for you."
One of the reasons why Medicare Rights urges beneficiaries to ask questions before making their health coverage choices during the Fall Open Enrollment Period, is that although people who become unsatisfied with their Medicare Advantage plan will have the opportunity to switch to Original Medicare during the MADP, they may not be able to get a Medigap plan to fill the gaps in coverage, or their Medigap choices may be limited.
Medicare Prescription Drug CoverageMedicare beneficiaries in possession of a Part D prescription drug plan are advised to not just find out if a plan covers their drugs, but pay particular attention to coverage restrictions, such as quantity limits, prior authorization and step therapy.
Questions on "How To Choose the Part D Plan" either as a stand-alone drug plan or a drug plan, which is part of a Medicare Advantage plan can be found here.
The Medicare Rights Center recommends for beneficiaries to call the plan in order to confirm any information they require and to keep a record of the conversation with the plan representative.
Medicare Rights also suggests enrolling in a plan by calling 800-MEDICARE rather than the plan itself.
Written by Petra Rattue
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
23 May. 2013. <http://www.medicalnewstoday.com/articles/236033.php>
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