Understanding Medicare 2011, New Plans, Old Plans?
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Review before December 31st
The new health care law will make some major changes to drug and health plans in 2011. It is extremely important to review your plan. Your choice to switch is only available from November 15 until December 31st. You will not be left without coverage. You will automatically be switched to another plan offered by the same insurer. But, this switch may not be the best plan for you and your needs.
You need to examine your plan’s costs and benefits for 2011. This information is listed in the “Annual Notice of Change.” This was a letter that was sent to you by Medicare. If you can’t locate it go online at www.medicare.gov, or call 1-800-633-4227 and request a copy.
The biggest changes involve PART D, prescription drug plans (PDP’s) and Medicare Advantage (MA) health plans. Two of the largest drug plans that will NOT be available in 2011 are:
AARP Medicare Rx Saver plan (with some 1.5 million enrolled)
Prescriba Rx Bronze (with 480,000 enrolled)
If you are with any other plan or these two listed above and the plan is NOT available, you will be automatically switched to another plan offered by the same insurer, or you can switch to your choice by December 31st
Some of the bigger changes are:
Costs--you get a 50% discount on brand-name prescription drugs, if you’re in the PART D doughnut hole. Co Pay – in an effort to try to close the doughnut hole, in 2011 50% discount will be given on brand name drugs and 7% off generic drugs. In 2010 you paid 100% of these drugs. The full price of the drugs will be credited towards out-of-pocket expenses. This means you will reach the catastrophic level sooner.
Premiums-- PART B higher income premiums, you will see a higher premium for PART D drug coverage. People who pay higher PART B premiums because of higher income will also pay higher premiums for PART D. This includes a taxable income above $85,000 a year or $170,000 married filing jointly.
Choice-- some plans are NOT available. You have to choose if your plan was eliminated. Between 28 and 38 PDP’s are available in each state and at least 10 MA plans.
Free Service--Traditional Medicare and most MA health plans have free annual physicals and many allow free mammograms and prostate screenings
Capped -- Yearly out-of-pocket medical expenses (not including premiums and prescription drug costs) in most MA plans will be capped in 2011. Out-of-pocket expenses include some plans, all your deductibles, all your co-pays, but NOT your monthly premiums. This figure is capped by law at $6,700/year. Some plans even lower.
Many private plans have also have been dropped. If you were enrolled in a private fee-for-service (PFFS) plan that no longer exists, you need to choose or return to traditional Medicare.
Stand alone drug plans will go up by $1 per month. AARP Medicare Rx Preferred will drop about 11%. CVS Caremark Value and Advantage Star will drop about 2%. Most others will see an increase.
Benefits in Traditional Medicare Plans will remain the same. What is the best plan for you? Use the plan finder on the website and check. The Medicare website is www.medicare.gov, or you can call them at 1-800-633-4227. The website details every plan in your area, and drug coverage. The site starts off “Medicare and Your 2011 Handbook.” There is a wealth of information. Don’t panic, only view one interest at a time. Click on Resource Location, and then go to Drug and Health Plans. The opening page will ask for your zip code, your Medicare plan number, your name, and they locate your info. Then you can read and write down questions and be prepared to make your choice. Your local Council of Aging, SeniorCenter, Library or town hall should be able to help or direct you to someone who can assist you.
