With the holiday season upon us, it’s easy to get busy this time of year. Some pretty important tasks can get left to the last minute. One of those important tasks is ensuring you are in the right health insurance plan in Medicare. Selecting the right plan is a personal choice, and a lot of thoughtful consideration goes into finding the right match. But just like the holidays, those key dates come whether or not you are ready.
Video: How to Understand Medicare Plans
Medicare Advantage 2013 Spotlight: Plan Availability and Premiums
This data spotlight report examines trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2013, premium levels and other plan features. It finds almost all plans offered this year will be available again in 2013, despite concerns that reductions in payments to plans under the Affordable Care Act would result in widespread pullouts from Medicare Advantage plans. If all beneficiaries choose to remain in their current plans, monthly premiums would increase about 10 percent, or $4, on average. The analysis also examines the types of plans available (HMOs, PPOs, etc.), changes in out-of-pocket limits, and the availability of special needs plans.
CareFirst BCBS’s Medicare plan gets high ranking from CMS
The ranking is for Medi-CareFirst’s BlueRx standard and enhanced prescription drug plans (Part D), and is an improvement over last year’s 4-star ranking. The CMS Medicare program each year rates all health and prescription drug plans in four categories, with ratings of up to five stars.
5 mistakes retirees make choosing a Medicare plan
It’s also easier to find quality plans this year, according to the Centers for Medicare & Medicaid Services, which has beefed up its star ratings system to alert consumers to the best-performing plans and remind those stuck in continuously low-performing ones that they can switch plans. Beneficiaries have 127 four-star or five-star Medicare Advantage plans from which to choose, up from 106 during open enrollment for 2012. And those in original Medicare have 26 high-performing prescription drug plans at their disposal, up from 13 last year.
Why Private Medicare Plans Don't Cost Less
Many contend that the government “overpays” for people enrolled in private plans, since traditional Medicare could have covered these patients for less money. But the reason it would have cost less is partly that the government has done a woeful job in figuring out how much to pay the private plans. The government compensates insurers based on the health of their enrollees at the start of the year. Plans with healthier patients receive less money than those with sicker ones to reflect the likelihood that healthier people will use less care. Healthier patients enroll in Medicare Advantage plans, so in, principle, plans should be reimbursed less by the government for enrolling these patients (the technical term for this process is “risk adjustment”). But for decades, the government has failed to determine who is healthy and who is sick with any precision, with the result that private plans receive larger payments to cover their patients’ costs than necessary. This botched payment system gives insurers an incentive to spend more time selecting the healthiest patients, and less time treating them more efficiently.
Medicare: Save Money on Premiums and Copayments in 2013
More plans offer lower copays at "preferred" pharmacies: In 2013, for example, more than half the 32 Part D plans in California will charge lower copays at preferred pharmacies than at regular network ones — with savings of between $2 and $28 for the same prescription. Sounds like a deal, but be careful: If a plan’s preferred pharmacies aren’t within a convenient distance, you may be better off in another plan.
Medicare Open Enrollment: Now is the Time to Review your Medicare Plan
Comparing Medicare plans is a relatively simple process, but having a friend or family member review the materials with you may be helpful. The official Medicare website has a tool at that helps you find and compare all of the plans available in your area. This is a great way to get started and at least gives you the overview of what your choices will be. When reviewing the plans, focus on the actual benefits they provide. For example, if you take prescription drugs, you might want to pay particular attention to the coverage offered while you are in the prescription drug coverage gap or “doughnut hole.” If you need help comparing coverage options, you can work with your local Area Agency on Aging for assistance and information. Remember: The open enrollment dates are strict! Oct. 15 – Dec. 7 is your only window of opportunity until 2013.
Medicare open enrollment: How can I find a better plan?
What about doctor availability? On the Medicare site you can directly compare up to three plans, and when I selected your current plan and these other two plans, I saw that your current plan says it has 1001-1500 “physicians and providers,” compared to 4001-5000 for the other two plans. For each plan you can click on “View provider and physician network website,” which takes you away from Medicare.gov and onto the plan’s own website, where you can search its provider directory to judge for yourself whether it has enough doctors to meet your needs.
What You Should Know About Choosing a Medicare D Plan
What drugs are you on? You may want to speak with your physician about changes that could reduce costs. What pharmacy do you want to use? You need to be sure your pharmacy accepts the plan you’re considering. How much does the plan cost? Do you want to go “a la carte” with a free-standing prescription drug plan (PDP) or choose one that combines medical benefits and prescription drug plans (MA-PD)? Are you on a retiree plan that limits your choices? Does your choice of plan affect your spouse’s plan? Be sure you understand the details of how the two interact. Where Can I Get Help? There are several excellent tools available to help you examine all of the plans and analyze your options. As a care manager, I have used all of these tools with great success:
Alexandria Seniors Can Get Help with Medicare Plan Changes
Open enrollment for making changes to Medicare D and Medicare Advantage plans is under way and will continue until Dec. 7. Changes made during this period will be effective Jan. 1. It is important to review your plan because Medicare Part D and Advantage plans are allowed to make changes in their premium costs, deductive, co-payments and formularies (the list of drugs covered by their plan), according to a city news release. Free counseling will be provided in Alexandria through VICAP, the Virginia Insurance Counseling and Assistance Program, and the Department of Community and Human Services Division of Aging and Adult Services.
Kaiser Permanente’s Medicare Plans Earn Top NCQA Health Insurance Rankings for 2012
About Kaiser Permanente Kaiser Permanente is committed to helping shape the future of health care. We are recognized as one of America’s leading health care providers and not-for-profit health plans. Founded in 1945, our mission is to provide high-quality, affordable health care services and to improve the health of our members and the communities we serve. We currently serve more than 9 million members in nine states and the District of Columbia. Care for members and patients is focused on their total health and guided by their personal physicians, specialists and team of caregivers. Our expert and caring medical teams are empowered and supported by industry-leading technology advances and tools for health promotion, disease prevention, state-of-the-art care delivery and world-class chronic disease management. Kaiser Permanente is dedicated to care innovations, clinical research, health education and the support of community health. For more information, go to: www.kp.org/newscenter.
Kaiser study: Romney’s Medicare plan raises costs
What’s more, as Sahil Kapur added, the study “does not project the longer-term implications for traditional Medicare. Many analysts warn that over time, sicker and older patients would choose traditional Medicare over private plans as private insurers tailored their plans to younger, healthier beneficiaries. Without strict rules and adequate risk adjustment, this would put traditional Medicare premiums on a ‘death spiral’ and the public plan would collapse.”