By Wiley P Long
The open enrollment period for 2011 Medicare Advantage plans and prescription drug plans is from November 15 to December 31 in 2010. You can find hundreds of different types of these plans across the country, with different co-insurance, deductibles and premiums so procrastinators will be doing themselves a favor by shopping early.
Starting in 2011, you will no longer have the traditional period from January 1 to March 31 to make additional changes once you're enrolled. That makes it even more important to compare all of your options thoroughly.
Approximately 11.8 million Medicare beneficiaries were already enrolled in Advantage coverage plans as of September 30. That amounts to almost a quarter of all the people enrolled in Medicare.
How Do Medicare Advantage Plans Work?
These plans are from private insurance companies that provide insurance for seniors and certain people with disabilities. These plans are subsidized by the government and the plans typically compete with extras not available in Original Medicare, such as dental, hearing or vision coverage. With the subsidies, their premiums were lower than standard Part B Medicare premiums, but subsidies have come under scrutiny. The federal government has frozen subsidies during performance evaluations. Some Advantage coverage plans may earn bonuses, but under-performing plans face a loss of subsidies and that may result in higher premiums.
Most of these plans include prescription drug coverage that is comparable to Medicare Part D. Advantage coverage plans are also typically managed care plans, such as a health maintenance organization (HMO) or a preferred provider organization (PPO) plans. You typically have to choose a primary care physician and see that doctor for a referral before you can see a specialist.
Your access to doctors, hospitals or other medical providers may be restricted to the plan's provider network, too. A few insurers do have what are known as Private Fee-for-Service plans, which may let you to see any doctor or use any Medicare-approved hospital. Such plans may have co-pay charges for doctor visits, but you wouldn't be required to select a primary care physician or get a referral in order to see a specialist.
All of these plans provide all of your Part A and Part B Medicare coverage, including emergency and urgent care coverage. The plans don't cover hospice care because Original Medicare will provide that coverage even after you enroll in one of the Advantage coverage plans.
How Do I Join One Of The Medicare Advantage Plans?
Generally, you can join an Advantage coverage plan if you have Medicare Part A and Part B and you live in an area where there is an Advantage plan that accepts new members.
If you are switching to a different Advantage coverage plan, all you have to do is join the new plan and you will automatically be disenrolled from your old plan. You will not have any lapse in your coverage.
As long as you are enrolled in any Advantage plan, you do not need to buy Medicare Supplement insurance. In fact, it is illegal for anyone to sell you any of the ten Medigap policies if you are in an Advantage plan. The benefits offered by Medigap policies are covered by Advantage plans and Medicare Supplemental insurance will not pay for your Advantage plan co-insurance, co-pays or deductibles.
What Do Medicare Advantage Plans Cost?
These plans have been inexpensive or even free in certain cases. With the freeze on government subsidies, you may see higher premiums, co-insurance or co-pay charges or reduced benefits. Nevertheless, these plans must continue to provide all of the benefits that are available through Original Medicare, though.
Medicare sets certain rules that all Advantage plans must follow, but these plans may include co-insurance charges on durable medical equipment like wheelchairs, add co-pay charges to see doctors, set an annual deductible you must meet before your prescriptions are covered or raise your premiums.
The only way to be sure you have the best Medicare supplement and are getting the most out of Medicare is to take a serious look at all of the Medicare Advantage plans and Medicare Supplement plans available in your area
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