September Newsletter 2009

Annual Enrollment: Top Mistakes to Avoid for 2010

November 15th marks the beginning of Annual Coordinated Election Period (AEP), better known as “annual enrollment”. November 15th through- December 31st is your opportunity to switch from your existing Medicare Advantage or Prescription Drug Plan to one that better suits your needs for 2010. If you are new to Medicare, annual enrollment is also your chance to enroll in a prescription drug plan or Medicare Advantage plan for the first time.

AEP is your chance to search for plans with:

• Lowest available out-of-pocket costs for the medications you take
• Expanded formularies
• Greater flexibility in choosing your healthcare provider

Top Mistakes to Avoid During AEP:

• Don’t assume the best plan for you last year is still the best plan for you this year. Prices and coverage change from year to year and you should use a plan comparison tool like the one found on PlanPrescriber.com to confirm which plan represents the lowest estimated costs for your specific medication usage
• Enroll BEFORE January 1st! Missing the December 31st deadline can leave you waiting until next year’s Annual Enrollment Period to enroll in a prescription drug plan as well as facing a premium penalty after you are able to enroll. The Medicare Part D late penalty is calculated by multiplying the number of months you’ve been without creditable drug coverage by 1% of the average premium for all Part D plans nationwide in any given year.
• Avoid common mistakes on your application form. Mistakes on an application form can result in delayed coverage
• Make sure your handwriting is legible
• Use the correct year’s application form: 2010
• Don’t use a P.O. Box as a mailing address. This is unacceptable on a Medicare Part D application. Be sure to enter the address for your residence
• Make certain that the name you enter on the application matches the name on your Medicare card exactly or the application will be rejected

*Remember that enrollment changes made during AEP will take effect January 1, 2010

Now is the time to do your research and ensure that you make an informed decision. Use PlanPrescriber.com or call 1-800-819-6906 to compare plan premiums, deductibles, and coverage of the medications you are taking. Comparison shopping is one of the best ways to avoid enrolling in coverage

Top Insurance Carriers to Drop Medicare PFFS Plans

Several insurance carriers, including Coventry and Wellcare, will be dropping one of the most popular Medicare Advantage plans, the Private Fee-for-Service (PFFS) option, leaving over 400,000 seniors without coverage in 2010. Medicare health plans that provide Private-Fee-For-Service do not limit physician choice to a predetermined network of doctors. On the contrary, people with a PFFS Medicare health plan can see any doctor who accepts Medicare payments. This flexibility on doctor choice has made it a popular option among senior citizens.

Due to changes including substantial reductions in subsidies for PFFS services that will take effect in 2011, several carriers are dropping this option from their Medicare Advantage plans. Don’t panic, though. You still have choices! Not all PFFS plans are going away, although some PFFS plans that remain may have higher monthly premiums or co-payments to cover cuts in government subsidies. Remember that there are other Medicare Advantage products to choose from, as well as Prescription Drug Plans and Medicare Supplement insurance. The important matter is to determine whether you can find similar coverage that does not require you to change your physician choice.

If you are losing your Medicare coverage in 2010, go to PlanPrescriber.com or call us toll-free at 1-800-819-6906. Our knowledgeable team of representatives is here to answer your questions and help you find a plan that suits your needs

Demystifying "ObamaCare"

With uncertainties surrounding the health care reform bill and with the Medicare Annual Enrollment date approaching November 15th, you might feel like you have more questions than answers. Until a health care reform bill is passed, it is uncertain how the final product will affect Medicare, but here’s what we do know:

• The Future of Medicare Advantage

  Don’t be overwhelmed by some of the proposals to reduce Medicare Advantage reimbursements. While there may be changes to MA plans down the road, the 1997 Balanced Budget Act includes a provision assuring Medicare beneficiaries a smooth and uninterrupted transition in their healthcare coverage should Congress mandate any program changes in the future.

• Separate Fact from Rumor

  Many senior citizens have been deeply upset set regarding the end-of-life counseling proposed as part of the Obama health care reform. This voluntary counseling has proved extremely controversial and may not be part of a final reform package. Currently there is no legislation to make the end-of-life counseling mandatory and seniors are increasingly making their opinions on the subject known to their elected representatives.

• Decreasing the “Doughnut Hole”

  The “Doughnut Hole” is reached when the full retail cost of covered medication purchased for a Medicare beneficiary exceeds $2,700 during one year. At this point, beneficiaries are forced to pay 100% of drug costs during this calendar year until they have surpassed $4,350 in covered out-of-pocket drug expenses or a new calendar year begins. Some health care reform proposals would gradually close the gap of this “doughnut hole” with a 50 percent price cut for brand-name drugs if a Medicare patient reaches the donut hole in coverage.

• A Focus on Preventative Care

  The proposals by Senator Max Baucus and others call for expanded preventative care benefits, including a free annual wellness visit for Medicare recipients. As stated in The Wall Street Journal article “Q&A: How Baucus’s Health Bill Would Impact Consumers”, Medicare beneficiaries also would not pay out-of-pocket fees for recommended services. Some proponents of health care reform have suggested instating a new Medicare commission that would control costs, but rest assured – they would not be allowed to change eligibility or benefits.

It is hard to say what will be in the final bill, but for now the best thing you can do is stay informed and let your representative know what your opinions are. Our experts at PlanPrescriber are here to help answer your questions. Go to PlanPrescriber.com or call us at 1-800-819-6906 today.