Annual Medicare Enrollment: Dates and Benefit Changes Seniors Should Know

By admin // No Comments » // changes, changes seniors, should

 

COLUMBUS – If you rely on Medicare for your health care needs, you should be aware of changes this year that will affect your benefits. As with every enrollment season, there are important things you should watch out for and consider when evaluating your coverage needs. The Ohio Department of Insurance can help you get smart when considering your options.

 

Enrollment Period Changes

This year, annual enrollment runs from Nov. 15 – Dec. 31, 2010. Additionally, from Jan. 1 – Feb. 14, 2011, Medicare Advantage enrollees can switch to Original Medicare. If you choose to change, you can also enroll in a Medicare prescription drug plan. In most cases you will not be able to change options outside the enrollment period, therefore you should take the time to carefully review your Medicare benefits and options now. Contact the Department’s Ohio Senior Health Insurance Information Program (OSHIIP) at 1-800-686-1578 for assistance evaluating your current coverage and for assistance determining what plans may best suit your needs. You can also attend one of OSHIIP’s statewide “Medicare Check-up Days” for in-person help. Visit for a listing of the events.

 

PPACA Changes

The Patient Protection and Affordable Care Act (PPACA) was signed into law in March. The health care overhaul law includes a number of significant changes to Medicare.

 

Improvements to Original Medicare

  • Preventive care – Beginning in 2011, Medicare beneficiaries will receive free preventive services including diabetes screening, mammograms, some vaccines and colorectal cancer screenings.
  • Annual physical exams – Beneficiaries are eligible for a yearly wellness exam to develop or update a personalized prevention plan.

Medicare Prescription Drug Coverage

  • Some beneficiaries enrolled in Medicare prescription drug plans face a gap in coverage often referred to as the “doughnut hole.” This is the portion of your annual drug expenditures, when you may be responsible for the costs of all medications.
  • In 2011, some beneficiaries who enter the “doughnut hole” will get a 50% discount on Medicare-covered brand name drugs and a 7% discount on Medicare-covered generic prescriptions while in the “doughnut hole.”

Medicare Advantage Plans

  • Beginning in 2011, Medicare Advantage plans cannot charge you more than traditional Medicare for chemotherapy, dialysis, skilled nursing care, and other services deemed appropriate.
  • Check with your plan to see if preventive care and wellness improvements to Original Medicare will be available to you.

Non-renewal Notices

 

Every year, some Medicare Advantage and Medicare prescription drug plans choose not to renew their Medicare contracts. If you received a non-renewal notice this year, the notice should also have included information about the options available in your area.

 

When weighing your options, compare coverages and costs to find the policy that best fits your health care needs. Remember, new Medicare Advantage plans could have different coverage limits, participating doctors and prescription drug lists than your current plan. If you choose Original Medicare, you might want to consider a prescription drug policy and/or a Medicare supplement insurance policy to augment your coverage.

 

Marketing Rules

 

State and federal rules are in place to protect you against abuses in the marketing and sales of Medicare prescription drug plans and Medicare Advantage plans. Individuals who contact you about any type of private Medicare coverage:

  • Must be licensed by the state. Check with the Ohio Department of Insurance at or 1-800-686-1526 to make sure the salesperson is a licensed agent.
  • May not make unsolicited contact such as door-to-door sales, cold calls or approaching you in a parking lot.
  • Must have an appointment to come to your home.
  • Must arrange in advance the type of products that will be discussed during a scheduled sales appointment. At the appointment, the salesperson may not try to sell you other types of insurance coverage other than the type(s) agreed upon in advance.
  • May not try to sell you non-health care related products (like a life insurance policy or an annuity) during a sales or marketing presentation of a Medicare prescription drug or Medicare Advantage plan.
  • May not attempt to sell you a plan in certain health care settings, such as a doctor’s office or a pharmacy.
  • May not attempt to sell you a plan at an educational event.
  • May not offer you free meals at promotional or sales events.
  • May not offer you gifts or other promotional items whose value exceeds $15.

Medicare Fraud

 

Unfortunately, not everyone who contacts you about switching Medicare plans has the best intentions. To protect yourself from scams, here are some additional tips:

  • Beware of door-to-door salespeople. Agents cannot solicit business at your home without an appointment. Do not allow uninvited agents into your home.
  • Do not give out personal information, such as Social Security, bank account or credit card numbers to anyone you have not verified as a licensed agent. Agents are not allowed to request such personal information in their marketing activities and cannot ask for payment over the Internet. They must send you a bill. Once you decide to purchase a plan and have verified that the agent is licensed, you may give the agent personal information to assist in enrollment and billing.
  • Verify that the plan you have chosen is an approved Medicare plan. All of the approved plans are available at www.medicare.gov or by calling 1-800-MEDICARE (1-800-633-4227).
  • Utilize the Ohio Department of Insurance’s Take Action: Protect Yourself from Fraud program to educate yourself about fraudulent insurance practices. Visit www.takeaction.ohio.gov for more information. You can  call the Department’s fraud hotline, , to report fraud or agent misconduct. 

Other Important Considerations

 

Federal assistance with Part B premiums is available to Medicare beneficiaries who meet certain income and resources requirements. If you think you may qualify, call your local County Job and Family Services office.  There is also a  program to help pay for Medicare’s prescription drug coverage (Part D) for beneficiaries with limited income and resources administered through the Social Security Administration.  Call for additional information on this program at 1-800-SSA-1213 (1-800-772-1213).

 

More Information

 

For more information about your Medicare options, the new required coverages under the PPACA or to use Medicare’s online Prescription Drug Plan Finder, go to www.medicare.gov. You can also call OSHIIP at 1-800-686-1578.

 

Find more information about your changing insurance needs and tips for choosing the coverage that is best for you and your family at www.InsureUOnline.org.

 

 

Similar Posts:

Share

Post comment