Medicare Advantage: Annual Election Period is near

If you are enrolled in a Medicare Advantage plan or Part D, please pay attention.  The Annual Election Period (also called the Open Enrollment Period) begins on October 15th and ends on December 7th.  During this period, you can fill out paperwork to change your Advantage plan or Part D plan. Your new coverage begins on January 1st.

If you are happy with your Medicare Advantage plan or Part D plan, you don’t have to do anything. Your coverage automatically continues into 2013.

Everyone enrolled in a Medicare Advantage plan (MA) or Part D, will be receiving, by the end of September, a package of information called the Annual Notice of Change (ANOC). Some people have already received their ANOC. But did they read it??? The ANOC is full of details you don’t care about – but there are several pages you should care about. Those pages tell you what co-pays are changing for 2013.  There might also be a list of drugs that are being moved from one tier to another – resulting in higher or lower co-pays. You need to review this list to see if any of your drugs are on it.

Medicare Advantage: What is changing?

Sorry, I can’t name names because I am an active insurance broker, and  someone might think I am promoting one plan over another. But I can tell you that most MA plans are raising the co-pay to see a specialist by $5. If your plan’s specialist co-pay was $30 in 2012, it will be $35 in 2013. If it was $45 in 2012, it will be $50 in 2013. (Ouch!) Hospital co-pays are also going up, in one case from $275 per day to $320 per day (days 1-5).

New Medicare Advantage plans in Tucson:

There are new Medicare Advantage (MA) companies coming to the Tucson area, and new plans are being offered by companies that have been here for a while.  This could be an Annual Election Period where lots of people decide to change their MA plan.

There will be lots of advertising on television and in newspapers, as well as mailings to people on Medicare.  There will probably be insurance agents in every supermarket and pharmacy around town.  And there could be some confusion about new plans and their networks. Medicare beneficiaries will need to pay attention and not make a hasty decision about a new plan that sounds good. Are your doctors contracted with the plan? How are your drugs covered? Make sure to get these questions answered.

Part D

I haven’t yet been to the training for Humana and UnitedHealthcare, the companies with the most popular Part D plans.  I will report on this later this week, but I don’t think there are major changes.

Read your ANOC!

If you are not paying attention, and you miss the Annual Election Period, you will be stuck in your Part D plan for all of 2013 (unless you move or you get a low-income subsidy for your drugs).  Last year, one Part D plan raised the premium from $32 to $71 !!  I had five clients enrolled in that plan and only one person (her husband actually) read the ANOC and knew about the change.

MA Disenrollment Period:  January 1 – February 14, 2013

Medicare Advantage has a disenrollment option from January 1 – February 14th.  During this period you can drop your MA plan and return to “Original Medicare” and get a Part D plan.  However, you cannot change to another MA plan during this period. And, you might not qualify for a Medicare supplement if you have health problems.

Annual Election Period Rules

Insurance agents cannot talk about plan details until October 1st.

Applications for plan changes cannot be accepted until October 15th.

Insurance agents must get a signed “scope of appointment” before meeting with you.

Insurance agents must check to make sure your doctors are in a plan’s network – unless you are willing to change your doctors.

Insurance agents must check to make sure your prescriptions are covered by the new plan you are considering.

Insurance agents are not allowed to “cold call” Medicare beneficiaries or knock on their doors to drum up new business.



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