The 2014 plan year standardized, combined Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) document will be mailed to current members of all Medicare Advantage (MA) plans, Medicare Advantage with Prescription Drug Coverage (MA-PD) plans, Prescription Drug Only (PDP) plans and cost-based plans offering Part D. MA and MA-PD plans must ensure current members receive the combined ANOC/EOC by September 30, 2013. Plans have the option to include Pharmacy/Provider directories in this mailing. All plans offering Part D must mail their Low-Income Subsidy (LIS) riders and abridged or comprehensive formularies with the ANOC/EOC to ensure current member receipt by September 30, 2013. Exception: Dual Eligible Special Needs Plans (SNPs) that are fully integrated with the State must mail an ANOC with the Summary of Benefits (SB) for member receipt by September 30, 2013 and then send the EOC for member receipt by December 31, 2013. Fully Integrated Dual Eligible SNPs that send a combined, standardized ANOC/EOC for member receipt by September 30, 2013 are not required to send an SB to current members. Note: With the exception of the ANOC/EOC, LIS Rider, and abridged or comprehensive formularies, no additional materials may be sent prior to the beginning of when marketing activities may begin on October 1.
2012 Medicare Deductibles and Premiums: Is This the Year You’ll Collect Deductibles at Time of Service?
The largest factor affecting the contingency margin for 2012 is the current law formula for physician fees, which will result in a payment reduction of about 29 percent in 2012. For each year from 2003 through 2011, Congress has acted to prevent smaller physician fee reductions from occurring. The 2012 reduction is almost certain to be overridden by legislation enacted after Part B financing has been set for 2012. In recognition of the strong possibility of increases in Part B expenditures that would result from similar legislation to override the decrease in physician fees in 2012, it is appropriate to maintain a significantly larger Part B contingency reserve than would otherwise be necessary. The asset level projected for the end of 2012 is adequate to accommodate this contingenIn 2012, Social Security monthly payments to enrollees will increase by 3.6 percent. The dollar increase in benefit checks is expected to be large enough on average to cover the increase in the Part B premium of $3.50 that most beneficiaries will experience. For those who were paying the standard premium of $115.40, their benefits checks will only increase.
How to Reform Medicare: First Stage to Fix the Current Program
The significant differences in official long-term projections, including projections of the program’s unfunded liability, reflect the differences in agency assumptions, particularly about the likelihood of the continuation of current law. The Medicare Trustees and the Congressional Budget Office (CBO) are required to make projections under current law, which assumes, for example, that the large Medicare Part A payment reductions are sustainable and that the projected 29.4 percent reduction in Medicare physician payment will be implemented in 2012. The Office of the Actuary in the Centers for Medicare and Medicaid Services (CMS) makes projections based on the premise that key elements of current law are simply “unworkable.” See John D. Shatto and M. Kent Clemens, “Projected Medicare Expenditures Under an Illustrative Scenario with Alternative Payment Updates to Medicare Providers,” Centers for Medicare and Medicaid Services, Office of the Actuary, May 13, 2011, at https://www.cms.gov/ReportsTrustFunds/downloads/2010TRAlternativeScenario.pdf (September 19, 2011).
Annual Statistical Supplement, 2011
d. Standard premium rate for voluntary enrollment by certain aged and disabled individuals not otherwise entitled to Hospital Insurance (HI). (Most individuals aged 65 and older and many disabled individuals under age 65 are insured for HI benefits without payment of any premium.) Beginning in 1994, a reduced premium is available to premium-paying HI enrollees with at least 30 quarters of Medicare-covered employment (either their own or through a current or former spouse if the marriage meets certain duration criteria). In most cases, a surcharge applies for beneficiaries who enroll after their initial enrollment period.