The Medicare Open Enrollment period runs from October 15 through December 7, 2012, the U.S. Centers for Medicare and Medicaid Services (CMS) and U.S. Department of Health and Human Services (HHS) announced on Friday.
This is the period when all people with Medicare can change their Medicare health plan and prescription drug coverage for 2013, if they wish to.
“If a person is satisfied that their current plan will meet their needs for next year, they don’t need to do anything,” CMS says.
Where to Find Information on Medicare Plans Available in 2013
Information on available 2013 plans can be found via the Medicare Plan Finder tool at Medicare.gov. Or, people with Medicare can call 1-800-MEDICARE (1-800-633-4227).
The Medicare Plan Finder enables you to conduct a general search for Medicare Plans available in your zip code area, or you can conduct a personalized search for plans available to you by entering your last name, zip code, Medicare Number, and effective dates of your current Medicare coverage. CMS indicates that the personalized search page “is secured to protect your personal information.”
The Medicare Formulary Finder is also available online to help people with Medicare find local plans that cover their specific medications. Both Finders and other helpful Medicare tools are available at Medicare.gov.
New 5-Star Quality Ratings Available to Help You Evaluate Quality of Medicare Health and Drug Plans
In a news release issued on Friday, October 12, 2012, the U.S. Department of Health and Human Services (HHS) also announced that it had “released the 2013 quality ratings for Medicare health and drug plans on the web-based Medicare Plan Finder.”
“During Medicare Open Enrollment, people with Medicare can use new star ratings [available as part of the Medicare Plan Finder] to compare the quality of health and drug plans being offered for 2013, and select the plan that best fits their needs,” HHS said in its announcement on Friday.
“Medicare plans are given an overall rating on a 1 to 5 star scale, with 1 star representing poor performance and 5 stars representing excellent performance,” HHS explained. “Users of the Plan Finder will also see a gold star icon designating the top rated 5-star plans, and a different icon for those plans who are consistently poor performers.”
For more details about the 2013 Part C and D Plan Quality Ratings released on Friday, HHS invites you to visit http://www.cms.gov/Medicare/Prescription-Drug-Coverage/PrescriptionDrugCovGenIn/PerformanceData.html.
More High Quality Plans and Choices Available in 2013 than Ever, HHS Says
In its news release on Friday, HHS announced that “people with Medicare have more high quality choices, and the performance of Medicare Advantage plans is improving.”
“In 2013, people with Medicare will have access to a wide range of plan choices, including more four and five star plans than ever before,” said HHS Secretary Kathleen Sebelius.
According to HHS, “in 2013:
- People with Medicare will have access to 127 four- or five-star Medicare Advantage plans. These plans currently serve 37 percent of Medicare Advantage enrollees, and may attract more with their improved quality ratings. In 2012, people with Medicare had access to 106 four or five star plans, which served only 28 percent of enrollees.
- People with Medicare will have access to 26 four or five star prescription drug plans, which currently serve 18 percent of enrollees. This is an improvement from 2012, in which 13 four or five star plans are serving only 9 percent of enrollees.”
“At the same time that quality is improving and benefits are increasing, premiums in the Medicare Advantage program are remaining steady,” HHS reported.
“Since the Affordable Care Act was passed in 2010 through 2013, Medicare Advantage premiums have fallen by 10 percent and enrollment is increasing by 28 percent,” HHS announced.
“The average estimated basic Medicare prescription drug plan (PDP) premium is projected to hold steady from last year, at $30 for 2013,” the HHS release indicated.
“As a result of provisions in the Affordable Care Act, Medicare is doing more to promote enrollment in high quality plans and alert beneficiaries who are enrolled in lower quality plans,” HHS said. “Now, persons with Medicare enrolled in consistently low performing plans (those receiving less than 3 stars for at least the past 3 years) will receive notifications to let them know how they can change to a higher quality plan if they choose to do so.”
“In addition, 5-star plans are rewarded by being allowed to continuously market and enroll beneficiaries throughout the year. In 2012, thousands of people with Medicare took advantage of this opportunity to join a top performing plan.”
“The Affordable Care Act also added new benefits to Medicare, including in the Medicare Advantage program. The health care law phases out the Medicare prescription drug coverage gap also known as the “donut hole.” In 2013, people with Medicare who reach the “donut hole” will receive approximately 53 percent off the cost of brand name drugs and 21 percent off the cost of generic drugs,” HHS announced.
In addition, “Medicare beneficiaries will continue to benefit from Medicare-covered preventive services at zero cost-sharing, including a yearly Wellness visit,” the HHS release pointed out.
How to Understand Medicare, Compare and Evaluate Plans, and Find the Best Plan for You
In late September, CMS began mailing out the booklet, “Medicare and You” for 2013, to those with Medicare. This is the official U.S. government Medicare Handbook, which contains quite comprehensive information about Medicare coverage, how Medicare works, and about What’s New and Important in 2013.
A copy of the publication is available for download here (as a 140 page PDF document): Medicare and You for 2013.
To help you compare and evaluate the quality of different Medicare plan options you may find using the Medicare Plan Finder referenced above, HHS provides further information about its 5-Star Quality Rating system in a pamphlet, entitled “Choose Higher Quality for Better Health Care.”
To help you select the best Medicare Drug Coverage plan for you, HHS provides “Things to think about when you compare Medicare drug coverage.”
Further information about Medicare Open Enrollment is available at the Medicare Open Enrollment Center on the CMS.gov website.
For further information about Medicare coverage and other financial issues for seniors and family caregivers, see the HelpingYouCare® resource pages on Legal and Financial Issues for Seniors & Caregivers, including:
- Financial Issues for Caregivers & Seniors
- Health Insurance & Long-term Care Insurance
- Medicare Coverage
- Medicaid Coverage & Asset Planning for Qualification
- Veterans Administration Benefits
- Other Financial Issues
- See the CareHelpFinder™ section for help finding a Financial Advisor
For more news and information about the Patient Protection & Affordable Care Act, President Obama’s signature Health Care Law, and about health care reform, see the HelpingYouCare® resource pages on VoicesForCare™, including:
- News on Health Care Reform;
- Editorials: What Needs Improvement, With Your Comments;
- Advocacy: Proposals for Reform, With Your Comments;
- Legislation: Pending & Recently Adopted; and
- International Health Care Compare: Information on Health Care & Long-Term Care Solutions in Other Countries.
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