MAYNARD, MA--(Octover 19, 2011) - Today PlanPrescriber (www.planprescriber.com), a wholly-owned subsidiary of eHealth, Inc. (NASDAQ: EHTH), released a list of ten tips for Medicare beneficiaries seeking to enroll in Medicare coverage during the 2012 Medicare Annual Enrollment Period. The Medicare Annual Enrollment Period (AEP) opened on October 15, 2011 and runs through December 7, 2011. In most cases, Medicare beneficiaries who wish to make changes to their Medicare Advantage or Prescription Drug Plan selections for 2012 must do so during the AEP.
As the baby boom generation begins to turn 65, more Americans will become eligible for Medicare and be called upon to make sense of the numerous Medicare coverage options available to them. These tips were designed to help Medicare beneficiaries understand and utilize the various resources available, the different Medicare enrollment periods and options for selecting the coverage that best fits their unique needs.
- Pay attention to enrollment period deadlines: If you have a Medicare Advantage plan, or plan to enroll in one, you can change that plan once a year, every year, during the Annual Enrollment Period (AEP). The same rules apply to stand-alone Medicare prescription drug plans. In some cases a person may qualify to change their coverage at other times during the year. If you want to enroll in a Medicare Supplement plan, you’re able to enroll in that plan for six months after you become eligible for, and enroll in Medicare Part B. But, after those six months, an insurer can usually ask you health questions. And, they have the option to deny you coverage based on your responses.
- Know ALL your costs – premiums are just one slice of the pie: It’s important to know what you’re going to pay each month – your monthly premium – but if you’re on a fixed-income, it’s much more important to know what your total out-of-pocket limit is in a given year. If you get sick or injured, some Medicare plans have deductibles, copayments and coinsurance that you may have to pay in addition to your monthly premium. Those costs can add up. And, in a worst case scenario, you could hit your “total out-of-pocket limit,” the maximum amount you would have to pay in one year. If you don’t know what your deductibles, copayments, coinsurance and total out-of-pocket limit are, you don’t know enough about your plan.
- Review your drug coverage heading into 2012: You should review your existing Medicare prescription drug coverage during the 2012 Medicare Annual Enrollment Period (AEP) and make sure it’s still the right plan for you. When PlanPrescriber.com reviewed people’s drug utilization and selection process during the 2011 Medicare AEP (which rand from November 15, through December 31, 2010), we found that the average person could save over $5001 per year by switching to a drug plan that was a better fit for their particular prescription needs. And, a similar study2 found that one-third (34%) of PlanPrescriber customers would not have coverage for at least one of their prescription drugs if they did not change their drugs, or their Medicare prescription drug coverage heading into 2011.
- Find out if your brand name drug is going generic in 2012: Patent protection is expiring for some popular brand name drugs, like Lipitor (in November 2011) and Plavix (May 2012.) This usually means lower cost generic versions for these drugs will become available. If one of your drugs is going generic in 2012, that could impact the plan you choose to enroll in. PlanPrescriber’s drug plan comparison tool calculates how much you’ll pay for your drugs and uses your drug list to forecast when you’ll hit Medicare’s prescription drug donut hole. If your drug turns generic before you hit the donut hole, you may be able to switch to the generic form of the drug, miss the donut hole and save money.
- Be a star!: The Affordable Care Act (health reform) requires a star rating system to be used for Medicare Advantage plans, beginning in 2012. Plans getting a rating of 1 to 5, with a 5 star rating equating to an “Excellent Performance,” and a 1 star ratings equating to a “Poor Performance.” If you’re lucky enough to have access to a 5 star plan, you should strongly consider it as an option for your coverage. One benefit of a 5 star plan is that you can enroll in it any time, even outside of Medicare’s annual enrollment period.
- Study your history (of Medicare plan rate increases): Medicare Supplement (usually paired with a Prescription Drug Plan) can offer benefits that effectively eliminate all of Medicare’s out-of-pocket costs. But, the price you pay each month for a Medicare Supplement can be expensive. And, the premiums often increase as you age. If you selected a Medicare Supplement years ago, and the plan’s premiums continue to rise each year, it may be time to talk to an expert and consider an alternate strategy for filling the gaps in Medicare.
- Have your doctor review your medications: During Medicare’s annual enrollment period, it is suggested that everyone should use a tool like the one at PlanPrescriber.com or Medicare.gov, to input their drugs and make sure they’re still in a competitive drug plan. But, as long as you’re making the list, use that opportunity to talk to your primary care doctor and have them review the medications you’re taking as well. Include over the counter medications and dietary supplements when you speak with your physician. If more than one doctor has prescribed medication for you, this review may be especially useful.
- Don’t travel without health insurance: Medicare will not pay medical claims outside the United States and its territories. However, certain Medigap plans provide emergency coverage outside of the United States. If you have a Medicare Advantage Plan, check on how medical treatment outside of your home location is covered.
- Don’t sweat the unknown: The nature of insurance is to protect against the unknown. You can make a good selection for yourself based on your current situation. Making an informed choice will give you confidence in your decision. AEP will come around again next year if you need to make corrections based on any changes you may face.
- Don’t be afraid to ask for help: Medicareis complicated, even for some Medicare experts. You can get help through your State Health Insurance Assistance Program (SHIP), PlanPrescriber, licensed health insurance agents who are certified to sell Medicare, family members or by calling Medicare at 1-800-Medicare, TTY users should call 1-877-486-2048 24 hours a day/7 days a week.
1 Source: PlanPrescriber Study: 93 Percent of Medicare Part D Beneficiaries Not in Lowest-Cost Prescription Drug Plan (http://news.ehealthinsurance.com/pr/ehi/planprescriber-study-93-percent-213339.aspx)
2 Source: Medicare Annual Enrollment Period (AEP): 34 Percent on Medicare Part D Were Taking at Least One Drug Not Covered by Their Plan During 2011 AEP: PlanPrescriber Study Finds (http://news.ehealthinsurance.com/pr/ehi/medicare-annual-enrollment-period-217252.aspx)
PlanPrescriber (www.planprescriber.com), a wholly-owned subsidiary of eHealth, Inc., is a leading provider of unbiased comparison tools and educational materials for Medicare Advantage, Medicare Part D Prescription Drug Plans, and Medicare Supplement insurance products. Medicare beneficiaries can take advantage of PlanPrescriber's no cost online advisor tools by logging on to http://www.PlanPrescriber.com. PlanPrescriber is a tool designed to help Medicare beneficiaries find a Medicare plan that covers their specific medical and prescription drug needs at the lowest possible out-of-pocket cost.
For more news and information about health insurance, health reform and Medicare, visit eHealth's consumer blog: Get Smart - Get Covered.
Medicare has neither reviewed nor endorsed this information
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