Medicare Changes Set for 2011

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As we’re heading into the final quarter of 2010, many eyes are on what will happen in 2011 with regard to changes to Medicare.

There’s been quite a lot of controversy about the new Affordable Care Act,” comments Alan Weinstock, insurance broker, at “Many people, especially seniors, are confused about how this new law will affect their Medicare or other health insurance coverage.”

2011 Medicare Changes

Well, according to the National Council on Aging, here is what Medicare beneficiaries can expect in 2011:

  • Annual Wellness Visit: Starting 12 months after their initial Medicare exam, beneficiaries can have an exam with their physician every 12 months thereafter without paying any deductible or co-pays.

  • Closing the Donut Hole: Medicare beneficiaries who reach the gap, known as the “donut hole,” in prescription drug coverage in 2011 will get a 50 percent savings in name brand drugs along with a reduction in costs for generic drugs. Additional discounts will continue up through 2019.

  • Medicare Advantage Plans: It is important to note that there is a new, shorter annual open enrollment period from January 1 through February 15, 2011. Medicare beneficiaries enrolled in a Medicare Advantage plan can use this 45-day enrollment period to change from Medicare Advantage to original Medicare only. They cannot change to another Medicare Advantage plan.

In addition, a special enrollment period to join a prescription drug plan will also apply, although there will not be a guaranteed issuance of a Medicare Supplement Plan, or Medigap, unless other rights apply.

Medicare beneficiaries who are enrolled in a prescription drug and/or Medicare Advantage plan and who have questions about how changes from the Affordable Care Act (ACA) might affect them, should consider contacting their state Senior Health Insurance Program (SHIP), a free statewide health insurance counseling service for Medicare beneficiaries and their caregivers.

Medicare Beneficiaries in California Have HICAP

California seniors can reach out to service organizations for assistance. There are counselors who are available through the Health Insurance Counseling and Advocacy Program (HICAP), a volunteer program that provides free, unbiased Medicare counseling and information.

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