Medicare Advantage: Changes for 2012

Most seniors seniors enrolled in Medicare Advantage and Part D have already received mailings from their plans documenting how their coverage will change for 2012.  From what I have learned thus far, changes for plans in Arizona are not major, but costs for seniors will be higher in 2012.

Co-pays in many Medicare Advantage plans are going up by $5 for visits to specialists (as high as $45). Some plan co-pays for hospital stays will be over $300 per day (but just days 1-5).  Part D drug plan premiums are going up a few dollars.

Note to seniors:  Read the mail from you Medicare Advantage or Part D plan!!

Here is a press release from the Center for Medicare Advocacy:

Fall is the time for Medicare beneficiaries to explore their options regarding Part D prescription drug and Part C Medicare Advantage plans.  In years past, the annual enrollment period began in mid-November and lasted to the end of the year, with any changes or choices made effective January 1st.  Starting this year, that time period has been moved up.  This year the Annual Coordinated Election Period (ACEP) for Medicare Advantage and Medicare Part D prescription drug plans will start on October 15th and end on December 7th.[1]  This means that Medicare beneficiaries will have to analyze their options and make choices earlier than in previous years.

During the ACEP, often referred to as “open enrollment,” Medicare beneficiaries who do not have a Part D plan can enroll in one, and those who do have Part D coverage can change plans.  Beneficiaries can also return to traditional Medicare from a Medicare Advantage (MA) plan, enroll in an MA plan, or change MA plans.

Beneficiaries who are satisfied with their plan in 2011 still need to review their plan options for 2012.  Part D and MA plans may have made changes to their coverage, provider networks and other plan features.[2]   Starting October 1, 2011, plan information for 2012 will be available on the Medicare Plan Finder at[3]  Medicare Advantage and Part D plan sponsors are allowed to start marketing their plans on October 1st.

It is likely that many beneficiaries will miss the new December 7th deadline for making any plan changes.  CMS says it is conducting outreach about the earlier deadline and that it will monitor the issue of beneficiaries who miss the deadline.  However, as of the date of this Alert, CMS has no public plans to allow a Special Enrollment Period (SEP) for individuals who miss the December 7th deadline.  Therefore it is critical that beneficiaries be informed of this change in dates.  In addition, those who miss the deadline should complain to CMS.

More from the press release:

The Medicare Advantage Disenrollment Period (MADP) from January 1st through February 14th:

During the MADP, a beneficiary can switch from an MA plan to traditional Medicare. The new MADP also provides an opportunity to pick up Part D drug coverage for those who do not already have it.

When disenrolling from an MA plan during the MADP, the effective date of disenrollment is the first day of the month following the date the disenrollment request is received. Thus, disenrollment requests received by MA organizations in January are effective February 1; those received February 1 through February 14 are effective March 1.[7]

During the MADP, an individual using the MADP to disenroll from an MA plan is eligible for a special enrollment period (SEP) to enroll in a stand-alone Part D prescription drug plan, regardless of whether the MA plan from which the individual disenrolled included the Part D drug benefit. The old OEP did not allow a beneficiary to add Part D coverage if he or she did not previously have such coverage at the beginning of the calendar year.

Beneficiaries are advised to enroll in a PDP as close to the time of disenrollment from the MA plan as possible in order to avoid having a gap in drug coverage.  For example, a beneficiary who disenrolls from an MA plan on January 31 and enrolls in a prescription drug plan (PDP) on February 1 would return to traditional Medicare on February 1, but would not have drug coverage until March 1.


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One Response to "Medicare Advantage: Changes for 2012"

  1. W.k. says:

                                                                                                    WHAT SHOULD HAPPEN   Congress and the White House should stop squandering the people’s money. There are many places to cut, as discussed herein, and use savings to improve quality of basic invested entitlements.   Congress should transition to improving the medical system.  Vote opponents to this “out”.  Citizens come first.       It is time the U.S. reduces human rites and police activities for the World by lobbying the U.N., NATO, and Interpol to “take on more”.  800 bases in 63 countries across the world should be reduced. Examples are fewer forces in, Bosnia, Germany, Philippines and Okinawa.Starting with Iraq, only train for self reliance. In Afghanistan train and diminish corruption by requiring accounting practices for aid, substituting minerals mining and food crops for drugs. $34 billion lost in service contracts. Its time for oil producers to pay for military supplies and consulting.     Cut bloated federal bureaucracy and expenses.  Combine CDC, EPA and FDA. Combine the FAA, NHTSA and DOT. Combine GAO and CBO. Eliminate “must spend all”.  Return “unused” yearly budget to the treasury. Cut budgets (other than entitlements) on an average of 10%. Implement GAO’s report to Congress on eliminating duplication, overlap and fragmentation in 81 of the federal government’s departmets, agencies, programs, offices and initiatives.                                  Eliminate all 32 czars Mr. President.  Reduce your 469 member staff which makes nearly 39 million per year!  Halt first lady $180,000 air force one vacation trips. Stop “multi million dollars per day” presidential-family foreign trips.            Contribute to only one of: The World Bank or International Monetary Fund or U.S. Agency for International Development and cut U.N. funding.    Reduce foreign aid bribery. For example, no aid to oil rich -Iraq.   Halt $ 500 million yearly aid to Palestinians.  Slash $1.3 billion annually to Egypt and Pakistan!    Charge bailed companies (TARP) for their huge executive bonuses at taxpayer expense.  Government should sell shares to recoup for taxpayer.  Billions still owed?                   Congress should reduce “stimulus” expenditures by halting over budget and vote bribery “earmarks”. Example: Stop “cow burp” and “drug smoking monkey” studies. Take back $13 billion unspent in states. Eliminate subsidies or tax credits that smell “earmark”. Congress should not pay student loans for their staff or family from their operating budgets.  Please- no renting of private or military aircraft. An example was Pelosi’s family of $2.1 million for over 2 years.  Congress should set commercial travel cost standards and controls.    Reduce medical cost by: allowing purchasing in any state, “tort reform”, and reducing “red tape”. Reduce Medicare fraud by expediting billing cost speed, and doctor/patient integrity screening within state controlled local provider groups.    Congress should enforce existing immigration laws and implement “no illegal birthrights”.  Entitlements or benefits should be for only citizens. Deport criminal “illegals”.   Only deportees and workers on Visa/Guest Programs qualify for needed medical benefits. Complete an improved fence. 56% of this border is uncontrolled.    Corporations and retirees should receive tax reductions for healthcare plans. These actions will improve funding for:” Medicare”, “Medicaid, and “Veteran’s Affairs”.         Healthcare quality can be at least that for Congress or the Federal Employee Health Benefits Program (FEHBP). Additional benefits are: dental coverage, improved visual coverage, no drug “donut hole”, no pre-existing conditions, no deductibles and co-pays except for extended skilled level nursing.    Other benefits are aid for unemployment compensation and Social Security with reinstated realistic cost of living increases.

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