Allsup Explains What’s New for Medicare Annual Open Enrollment Period

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Medicare annual open enrollment begins Oct. 15; new benefit choices take effect Jan. 1, 2013

By closely reviewing your Medicare coverage from this year and changes you expect in 2013, it’s possible to see savings with your healthcare costs.

In just a few weeks, millions of people will receive notice that Medicare’s annual open enrollment period is approaching. That means it’s time to review their current coverage and decide if they would benefit from switching plans for 2013, according to Allsup, a nationwide provider of Medicare plan selection services and Social Security disability representation.

During the Medicare annual enrollment period, Oct. 15 to Dec. 7, all Medicare beneficiaries may change their Medicare coverage for the coming year. This includes anyone using traditional Medicare, Medicare Advantage and prescription drug coverage.

“By closely reviewing your Medicare coverage from this year and changes you expect in 2013, it’s possible to see savings with your healthcare costs,” said Mary Dale Walters, vice president of Allsup and the Allsup Medicare Advisor®, a Medicare plan selection service for Medicare-eligible individuals. “It’s important to get started early.”

In addition to reviewing Medicare plan changes, beneficiaries should make sure they are taking advantage of savings provided through the Affordable Care Act (ACA).

“The healthcare law is helping reduce prescription drug costs by gradually phasing out the donut hole, which is when Medicare beneficiaries must pay for medications out of their own pockets,” Walters said. “It also has made it easier to take advantage of preventive medical services through Medicare.”

What To Expect: Medicare Coverage 2013

Since it was passed, the ACA has helped nearly 18 million individuals with traditional Medicare get at least one preventive service at no cost with no deductibles or co-pays. The law also has helped nearly 5.4 million people with Medicare save more than $4.1 billion in out-of-pocket expenses on prescription drugs as it closes the Medicare Part D donut hole, according to the U.S. Department of Health & Human Services (HHS).

As these benefits continue, Medicare beneficiaries can expect the following with their 2013 coverage:

  • Medicare recipients reaching the drug donut hole will benefit from increased coverage. The gap in prescription drug coverage starts when someone reaches the initial coverage limit, estimated at $2,970 for 2013, and ends when they have spent $4,750. (These are increases of $40 and $50, respectively, from 2012.) Catastrophic coverage begins at this point. During the donut hole, all costs are covered by individuals out of their own pocket. In 2013, individuals who reach the donut hole can receive a 50 percent discount on covered brand name drugs (the same as 2012), as well as 2.5 percent of coverage now paid by plans. Generic drug discounts increase to 21 percent from 14 percent.
  • Cost for Medicare Part B coverage may increase. The 2012 monthly premium for Medicare Part B (medical insurance) coverage is $99.90, a decline from 2011. Preliminary forecasts indicate that Part B premiums are likely to increase for 2013. Factors such as the rollout of the Affordable Care Act and the federal fiscal year 2013 budget may affect the cost of premiums in 2013; however, more detailed information probably won’t be available until Medicare’s annual open enrollment period begins Oct. 15.
  • Prescription drug (Part D) increases deductible; holds on premium costs. The Part D initial deductible will increase by $5 to $325 in 2013. Drug cost sharing during catastrophic coverage is $2.65 for generic or preferred drugs (multi-use source) and $6.60 for all other drugs. Premium costs in 2013 are expected to stay constant, averaging $30 per month (compared to $29.67 per month in 2012), according to the HHS. In addition to costs, individuals should review how any changes to drugs covered under their plan could affect their individual circumstances.
  • Medicare Advantage plans see changes. Medicare Advantage participants should review 2013 plan changes as soon as they receive information from their providers. Changes could include costs such as premiums, deductibles and co-pays, as well as changes to covered procedures, tests and other provisions. Some plans may be eliminated, requiring enrollees to choose a new plan for 2013 or default to traditional Medicare Part B. Enrollment in Medicare Advantage plans continues to increase, with 10 percent more Medicare beneficiaries choosing these plans for 2012 compared to 2011. The average number of plans available to eligible individuals declined slightly from 24 plans in 2011 to 22 plans in 2012. The average number of plans for 2013 will not be known until later this year.

According to Walters, most Medicare beneficiaries should receive their Annual Notice of Change (ANOC) and Evidence of Coverage (EOC) from their existing Medicare Advantage and Medicare Part D plan providers by Sept. 30.

“Take time to review the information you receive and look at all of your Medicare options,” Walters said. “You may find more affordable coverage through a different combination of plans—whether Medicare Advantage or traditional Medicare with Part D and Medigap plans. Keep in mind that you may see a lot of ads for Medicare plans, but there could be a plan that’s perfect for you that isn’t getting a lot of attention with ads and mailers.”

It’s important to compare this year’s coverage and understand the changes for 2013, especially when evaluating costs and anticipating healthcare needs for next year. “If finding the right Medicare plan becomes time-consuming, confusing or stressful, remember that an expert like Allsup can do the in-depth research, sort through plans, and make it easier to identify and choose the option that best meets your specific needs and lifestyle.”

For an evaluation of your Medicare options, call an Allsup Medicare Advisor specialist at (866) 521-7655 or visit http://Medicare.Allsup.com.

Ask questions and find Medicare resources during the Allsup True Help® Disability Web Expo on Thursday, Sept. 27, from 9 a.m. to 4 p.m. CST. This free, live online event allows visitors to talk directly with Medicare specialists via the Internet. Register to attend at WebExpo.Allsup.com.

ABOUT ALLSUP
Allsup is a nationwide provider of Social Security disability, Medicare and Medicare Secondary Payer compliance services for individuals, employers and insurance carriers. Founded in 1984, Allsup employs more than 800 professionals who deliver specialized services supporting people with disabilities and seniors so they may lead lives that are as financially secure and as healthy as possible. The company is based in Belleville, Ill., near St. Louis. Visit http://www.Allsup.com or connect with Allsup at http://www.facebook.com/Allsupinc.

The information provided is not intended as a substitute for legal or other professional services. Legal or other expert assistance should be sought before making any decision that may affect your situation.

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Mary Jung
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Rebecca Ray
Allsup
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