Seniors and people with disabilities to choose new healthcare coverage

Oct 14 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.