From Allsup (10/13/09):
Healthcare Reform, Coverage
Changes Highlight Key Questions for Medicare Annual Enrollment Season, Allsup
Says
Medicare
annual enrollment provides less than 50 days—Nov. 15 to Dec. 31—for
Medicare-eligible individuals to evaluate and choose the plan that best meets
their healthcare needs in 2010
Belleville,
Ill. – October. 13, 2009 – More than 600,000 seniors and people with
disabilities will be required to choose new healthcare coverage during the
upcoming Medicare annual enrollment because their current plan is being
eliminated. However, millions more could benefit by changing to a plan that
better fits their needs, according to Allsup, a
nationwide provider of Social Security disability representation and Medicare
services.
“Annual
enrollment is the best, single opportunity to examine your Medicare coverage to
make sure it truly meets your needs,” said Paul Gada, Allsup’s personal
financial planning director and product manager for Allsup
Medicare Advisor®. Allsup Medicare Advisor
is a Medicare plan selection service that helps people understand and choose
the most affordable and appropriate Medicare plan for their healthcare needs.
(Allsup is not a Medicare plan provider.)
“If there
is a gap between what you need to cover your healthcare costs and what you have
right now – this is the time to close the gap,” he said.
Medicare
annual enrollment runs from Nov. 15 through Dec. 31, providing seniors and
those with disabilities a finite amount of time to evaluate their options.
Below, Allsup outlines common questions people have about annual enrollment.
Medicare
Annual Enrollment: Common Questions
1. What are the biggest Medicare changes for 2010?
Traditional Medicare is not experiencing any changes in 2010.
However, Medicare Advantage plans and prescription
drug plans, or Part D plans, are experiencing changes.
About 18 percent of Medicare Advantage plans are being eliminated,
generally because they were too similar to other plans offered by the same
company or had very low enrollment. Medicare
Advantage plans are private Medicare plans that offer the same coverage as
traditional Medicare, plus may include additional benefits such as prescription
drug coverage and vision, hearing and dental care. Even with the reduced number
of Medicare Advantage plans, there are still thousands available.
Some prescription drug plans are also leaving the market, but many
still remain. Stand-alone Part D plans and drug formularies in Medicare
Advantage plans also may add or drop coverage for certain prescription
medications and experience premium changes. “You want to make sure the
prescription drugs you take are still covered under your current plan,” Gada
said.
“This is the best time to take a look at what your plan covers,
how that is changing for next year and the impact on your healthcare needs and
expenses,” he added.
2. Will
healthcare reform affect my 2010 Medicare options?
No. The proposed legislation won’t affect Medicare plan options
for 2010.
3. How will costs change for 2010?
A majority of Medicare participants will not see an increase in
the basic premium they pay for traditional Medicare. Premiums will increase for
some Medicare Advantage and Medicare prescription drug plans.
The average monthly premium for Medicare Advantage plans will
increase by $7 to $39. However, nearly 87 percent of Medicare beneficiaries
have access to Medicare Advantage plans that do not require additional
premiums. Additionally, more Medicare Advantage plans available for 2010 will
cap out-of-pocket costs to $3,400 or less, providing beneficiaries with an
added protection against unexpected costs.
The average monthly premium for prescription drug coverage (Part
D) also will increase by $2 to $30. Most Medicare Advantage plans include
prescription drug coverage, so this increase generally applies to only those
choosing traditional Medicare with an additional prescription drug plan.
4. Why
would I want to change plans?
Reasons people change plans include:
- You are unhappy with your
existing coverage or provider;
- You are experiencing changes
in your health;
- You expect changes in
medical needs for the coming year; or
- Your current plan has
changed and no longer meets your needs.
As with other insurance, you should shop around at least every few
years to ensure you are getting the best value. “Take a look at your costs for
2009. What did you pay for your premiums, co-pays and deductibles?” asked Gada.
“Then consider whether your coverage matched your needs. Did you have a
hospital stay? Did you make several visits to your family doctor, or did you
visit specialists, too?
“If your costs were too high or you paid more than you expected
to, then you owe it to yourself to see if there is a plan that better meets
your needs,” Gada said.
5. What changes can I make during annual enrollment?
You can:
- Move from traditional
Medicare to a Medicare Advantage plan;
- Move from a Medicare
Advantage plan to traditional Medicare; or
- Add a Medicare prescription
drug plan (Part D) if you do not have prescription drug coverage.
6. If I
decide to change plans during annual enrollment, what do I need to do?
You need
to identify and enroll in the new plan before Dec. 31. You can research the
available plans and enroll on your own, or you can use the experienced help of
an independent Medicare plan
selection service like Allsup Medicare Advisor. Because most
people have dozens of plans from which to choose, they can make the process
easier on themselves by using an objective Medicare specialist, who helps
identify the best plans for their needs and assists with Medicare enrollment.
7. If I
do not want to change plans, how do I keep the plan I have?
If you do nothing, you are re-enrolled in your current plan. If you
are in a Medicare Advantage plan and it is being terminated, and you do
nothing, you will be enrolled automatically in traditional Medicare. Keep in
mind that traditional Medicare may have higher out-of-pocket expenses and more
limited coverage than your previous Medicare Advantage coverage, so this may
not be the optimal choice.
8. Where
can I get more information?
All Medicare beneficiaries enrolled in a Medicare plan should
receive annual enrollment information from their Medicare Advantage or Medicare
Part D plan. Additionally, Medicare beneficiaries should receive a copy of the
2010 Medicare
& You book from the Centers for Medicare & Medicaid
Services (CMS). For
additional Medicare assistance, Allsup offers a free
screening to help you determine eligibility for Allsup Medicare Advisor
at http://ama.allsup.com.
About Allsup
Allsup is
a nationwide provider of Social Security disability, Medicare and workers’
compensation services for individuals, employers and insurance carriers.
Celebrating its 25th anniversary in 2009,
Allsup employs more than 600 professionals who deliver specialized services
supporting people with disabilities and seniors so they may lead lives that are
as financially secure and as healthy as possible. The company is based in
Belleville, Ill., near St. Louis.
For more
information, visit www.Allsup.com.
The information provided is not intended as a substitute for legal
or other professional services. Legal or other expert assistance should be
sought before making any decision that may affect your situation.
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