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(HealthNewsDigest.com) – Some Medicare beneficiaries could have a hard time giving “thanks” this year on Nov. 24. Why? Because the day before Thanksgiving, Nov. 23, the Joint Committee on Debt Reduction (the “Super Committee,”) will vote on a proposal to cut $1.5 trillion from our nation’s budget deficit.
If the proposal is passed, it is likely to include plans to restrain the growing cost of Medicare. If it is not passed, Medicare’s growth would automatically be reduced by two percent in 2013. This possibility has many seniors wondering what this means for them and their Medicare coverage.
Medicare’s Annual Enrollment Period (AEP) is the one time of year when most of the program’s beneficiaries can review and possibly update their current stand-alone drug coverage or Medicare Advantage coverage. The enrollment period for 2012 is currently underway, and according to licensed eHealthInsurance agents, the uncertainty about Medicare’s future has many seniors wondering what to do.
When we surveyed a number of our licensed eHealthInsurance Medicare agents, they all had the same response: the most common questions being asked during this year’s enrollment period focused on Medicare’s future.
What questions are Medicare beneficiaries and caregivers asking?
Question 1: Are Medicare Advantage plans going away – should I try to switch to a Supplement plan?
Answer: First, there was good news about the Medicare Advantage program this year. Overall, Medicare Advantage plan premiums are down four percent for 20121. Medicare Advantage plans offering prescription drug coverage and a cap on your out-of-pocket costs (two benefits not provided by “original Medicare”) continue to be available for $0 per month throughout most of the country. And, these $0 plans include a basic prescription drug benefit, which will be increasingly valuable in 2012 when popular drugs like Lipitor and Plavix are scheduled to be available in generic form.
Second, any reductions in Medicare spending could easily affect Medicare Supplement plans as well as Medicare Advantage plans. Both types of plans are subsidized in some way by the Medicare program. And, the less the government has to spend on Medicare, the more an insurance company would have to cover to fill in those gaps.
Finally, it can be hard to enroll in a Medicare Supplement plan after your first six months on Medicare Part B. If you miss those first six months, the insurance company has the option to decline your application based on your health status.
Question 2: Will my Medicare Part B premiums increase more than my Social Security cost of living adjustment (COLA)? Answer: There is actually a rule in Congress that Medicare premium increases cannot be higher than Social Security cost-of-living adjustments. The COLA for this year is about $433 dollars for most people. And, the Medicare Part B premium increase was $3.503 for most people.
Question 3: Is my doctor still accepting my Medicare Advantage plan? Is my hospital covered by this plan?
Answer: While finding a physician who accepts Medicare can be an issue, the federal government continues to monitor the quality and access standards of Medicare Advantage plans. A good agent can help you review the physicians who are accepting their Medicare Advantage plan in your zip code.
Question 4: What should Medicare beneficiaries and caregivers do this year to make sure they’re getting the best bang for their buck out of Medicare?
Don’t go on auto-pilot: A recent Opinion Research survey found that only about 534 percent of seniors on a Medicare Part D or Part C plan say they will review their coverage before 2012. Too often, Medicare beneficiaries don’t realize that Part C and D plans can change from year to year. Costs and drug coverage may change; deductibles and co-pays may change; and your health may change. So, what worked for you in 2011 may not work in 2012.
Do a quick check-up online, or get someone to help you: People tend to want to avoid a review of their Medicare coverage because it’s a hassle. But, there are a number of Internet sites that can reduce the hassle of reviewing your coverage. Sites like PlanPrescriber.com (owned by Plan Prescriber, Inc.), eHealthMedicare.com (owned by eHealthInsurance Services, Inc.) and Medicare.gov (the government website) make it easy for you to review plans and benefits side-by-side, and get a sense of what plan might work best for you. Or, if you don’t want to use the Internet, you can contact Medicare, your state department of insurance, the insurance company, or work with a licensed agent who represents several insurance companies, like eHealthInsurance.
Bring a list of drugs, doctors and bills: When working with a licensed agent, be sure to bring a list of the prescription drugs you’re taking, including the dosages and frequencies. And, if possible, have your medical bills from the past year handy as well so you can reference what you’ve been spending on health care. You also want to have the names of your preferred physicians and pharmacies handy.
Be flexible: The average Social Security Benefit is $1,2292 per month. But, a recent eHealth survey found that 79 percent of seniors said they would not change their health insurance plan to potentially save up to $100 month if it meant switching doctors. But, $100 per month is almost 10 percent of the average social security check. If your money is really tight, try to be open-minded about ways you can reduce expenses.
1http://www.hhs.gov/news/press/2011pres/09/20110915a.html
2 http://ssa-custhelp.ssa.gov/app/answers/detail/a_id/13/~/average-monthly-social-security-benefit-for-a-retired-worker
3http://www.ssa.gov/oact/cola/colaeffect.html
4 Data according to a national randomized phone survey conducted between October 28 and October 31, 2011 by Opinion Research Corporation and sponsored by PlanPrescriber.
Medicare has neither reviewed not endorsed this information.
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