Time Running Out to Change Medicare Plans


POSTED: Wednesday, December 15, 2010 - 11:53am

UPDATED: Wednesday, December 15, 2010 - 8:51pm

Are you on Medicare or do you know someone who is? If so, time is running out to make changes to next year's coverage plan.

Medicare's Annual Election Period ends December 31st. For a little over the next two weeks there is still time to enroll in Medicare Advantage or Medicare Part D. You can also choose to return to a traditional Medicare Plan.

If you do decide to make changes to your Medicare Plan, there is a lot to consider.

"Since there's a variety of Medicare Advantage programs out there, you want to first look at what's called the formulary. Make sure your drugs are included in the program you're enrolling in," said Sergio Archuleta, area sales manager for UnitedHealthcare in El Paso.

Archuleta provided some more advice for choosing what plan is right for you:

- Remember that you still have a choice in how you receive your Medicare coverage. Medicare Advantage plans will continue to be available in 2011 as an alternative to traditional Medicare for beneficiaries in the Dallas/Ft. Worth area. More than 11 million beneficiaries are enrolled in Medicare Advantage plans, which combine Parts A and B coverage and often also include Part D prescription drug coverage, all in one plan. These plans also often provide access to services and extra benefits not covered by traditional Medicare.

- Review the plan’s network to ensure that your doctors and hospitals are included. If you have a primary care physician or specialist you like, you’ll want to be sure that you can continue to see him or her at in-network rates in 2011. Likewise, if you prefer to receive care at a particular hospital, make sure it accepts the plan you’re considering.

- Understand how the plan can help you stay healthy. If you’re routinely screened for certain conditions, check to see if the plan will cover the screenings and what you will pay in co-payments and/or co-insurance. Some Medicare Advantage plans cover fitness club memberships and provide vision and dental coverage. If these “extras” are important to you, compare the plans available in your area to find one that meets your needs.

- Make sure your drugs are covered. Whether you’re enrolled in a Part D prescription drug plan or a Medicare Advantage plan that includes drug coverage, check the plan’s formulary, or approved drug list, to confirm that the medications you routinely take are covered. Also check the co-payments for your drugs so you’re not caught off guard by your monthly drug costs. Many plans offer very low co-payments for generic drugs, so that might be an option to discuss with your physician to help you save money in 2011.

- Consider the total costs of the plan. Many Medicare Advantage plans have a low or even zero-dollar monthly plan premium, but that’s not the only number you should check when comparing plan options. Some plans have a deductible that you must meet before you can begin using the plan’s benefits. Co-payments and coinsurance will also impact your out-of-pocket costs throughout the year. Generally speaking, the higher the monthly premium, the lower your cost-sharing will be when you access care.

- Take advantage of resources to help with your enrollment decisions. Look to your community for support -- seek help from family members, friends and neighbors, senior organizations, and your doctor and pharmacist, all of whom can add valuable perspective. To find out more about Medicare plans available in your area, visit www.Medicare.gov or call Medicare at 1-800-633-4227.

Keep in mind that the Open Enrollment Period has been eliminated, so you won’t have the opportunity to switch to a new Medicare Advantage plan from January through March. Because of this change, it is even more important to make the right choice now so that your plan will meet your health-care needs throughout 2011.

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