What Seniors Need to Know Before Making the Hard Choices

What Seniors Need to Know Before Making the Hard Choices

Many senior citizens will have hard choices to make between now and the end of the year. The Annual Enrollment Period for Medicare recipients began on November 15th and ends on December 31th. During this time seniors can make changes in their private Medicare coverage or search for new options.

Before we consider the options, let's review what Original Medicare covers. Original Medicare Part A covers inpatient hospital services at no charge to the beneficiary. Part B covers outpatient services and includes doctors and other health care providers, but requires a premium of $96.40 or $110.50 for current beneficiaries and $115.40 for new beneficiaries. Part C, which is called Medicare Advantage (MA) provides all the same benefits covered by Medicare, such as doctors and hospital services. But it may also provide extra benefits such as eyeglasses, hearing aids, or health club membership. And, finally, Part D covers prescription drugs and is offered only by private insurers. Both Part C and Part D may have varying monthly charges or no charges at all depending upon the type of plan or the beneficiary's income.

Beginning November 15th, seniors can change from one Medicare Advantage Plan (MA) to another; from Original Medicare and Prescription Drug Plan (MA-PD) to another Medicare Advantage Plan with the Prescription Drug Plan (MA-PD) or from Original Medicare and Prescription Drug Plan to a similar one. This year beginning January 1st the Open Enrollment Period is more important than the previous years when it was from January 1st to March 31st. During the 12 weeks, in the previous years, seniors were allowed to change from one Medicare Advantage Plan to another or back and forth from Original Medicare. This time those changes will not be allowed. During the six weeks from January 1, 2011 to February 14, 2011, seniors can only unregister from a Medicare Advantage Plan and reenter Original Medicare and join a Medicare Part D Plan.

With regards to Part D, in 2011 when beneficiaries reach $2,840 in total drug costs (what beneficiaries pay plus what the plan pays ) often referred to as the doughnut hole, beneficiaries will not have to spend as much out of pocket as in previous years. Now when beneficiaries reach this gap they will receive a 50% discount on all brand name drugs and a 7% discount on generic drugs.

Beneficiaries remain in the gap until the total costs of drugs reaches $6,440. The 7% discount, however, will not count toward the total costs of drugs. After reaching $6,440 in total drug costs, beneficiaries pay no more than 5% of the cost of the drugs allowed by the Plan. Low income beneficiaries may be eligible for Medicare Extra Help program which cover some of the Part D costs. Also, beyond costs, look for any rules the Plan sets out for getting the drugs that the doctor prescribes.

So taking all these matters into consideration, now is the time to compare plans, reassess your options,and make the hard choices.

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