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Medicare 2012…What you need to know during
(Family Features), October 12, 2011--
Medicare is different this year because of
health care reform, and if you’re not aware
of how this important program has changed,
Be aware of deductibles, co-insurance,
out-of-pocket limits and prescription drug
If you’re new to Medicare it’s important to
know that both parts of Original Medicare (A
and B) have deductibles. And, the Part A
deductibles are not tied to a calendar year.
Instead, they’re tied to a 90-day benefit
period, with some exceptions.
The Medicare Part B benefit also includes
coinsurance after you meet your deductible.
With coinsurance, Medicare pays a percentage
of each bill and you pay the rest (between
20 and 45 percent, depending on the
service), after applicable premiums and
New and existing benefits to help you fill
in Medicare’s gaps
People concerned about some of the gaps in
original Medicare have the option to enroll
in insurance products regulated by the
government but provided by private
companies. These are products designed
specifically to fill some of the different
gaps in Medicare.
—Medicare Part D stand-alone prescription
drug plans, which cover the cost of most
—Medicare Supplement plans, which cover
portions of the deductibles, coinsurance and
out-of-pocket costs not covered by original
—Medicare Advantage plans, which bundle
together the Part D drug benefit with some
additional coverage for deductibles,
coinsurance and out-of-pocket costs.
Each type of supplemental coverage has
different guidelines for when you can
enroll, change and cancel your coverage.
There are new Medicare annual enrollment
Most beneficiaries can change a Medicare
Advantage plan or stand-alone Medicare
prescription drug plan once per year during
Medicare’s annual enrollment period (AEP).
The dates for AEP run from October 15 to
December 7 in 2011.
Medicare Supplement plans have an initial
enrollment period, which occurs in the first
6 months after you enroll in Medicare Part B
and are 65 or older. During that time, you
can enroll in a Medicare Supplement plan and
not be declined. But, if you try to enroll
after the initial enrollment period, your
application could be declined based on a
review of your medical history.
But, if you want to switch from a Supplement
plan to an Advantage plan, the AEP is a good
time to make that switch.
It’s critical to compare drug coverage every
PlanPrescriber.com, an internet company that
allows people to compare Medicare plans
side-by-side, looked at 25,000 user sessions
on its website between November 15, 2010 and
December 31, 2010.
The site found that, on average, a user
could save over $500 per year — over $40 per
month — by reviewing their options and
changing their prescription drug plan.
Get star power in 2012
The Affordable Care Act requires a star
rating system to be used for Medicare
Advantage plans, beginning in 2012. Plans
get a rating of 1 to 5, with a 5 star rating
equating to an “Excellent Performance,” and
a 1 star rating equating to a “Poor
If you’re lucky enough to have access to a 5
star plan, consider it as an option for your
coverage. One benefit of a 5 star plan is
that you can enroll at any time, even
outside of Medicare’s annual enrollment