What You need to Know About Medicare in 2011

Special Guest Post By: Ross Blair, CEO, PlanPrescriber.com

Whether you enrolled in a new Medicare Advantage plan this year, or you didn’t change the plan you had last year, now is the time to review your coverage and be sure it meets your needs.

In 2011, people eligible for Medicare have just six weeks (January 1 through February 14) — last year it was three months — to be sure the coverage fits their needs and maximizes their cost savings.

There are also fewer options for changing coverage during the new Medicare Advantage Disenrollment Period (“MADP”) if you’re unhappy. Here are the changes you can make:

- People with a Medicare Advantage plan or a MA-PD plan (Medicare Advantage with prescription drug coverage) can switch to original Medicare and enroll in a stand-alone Part D prescription drug plan (PDP). If you go without the PDP, you’ll pay a penalty if you ever try to enroll in a PDP during another enrollment period.
- People cannot switch from one Medicare Advantage plan to another. This is new for 2011.
- People with a Medicare Advantage plan and a stand-alone PDP can switch to original Medicare, but they must keep their PDP.
- People already covered by original Medicare and a PDP cannot make any changes.

It’s enough to make anyone’s head spin, but anyone on Medicare who doesn’t take the time to research their options and choose the plan that best fits their needs could leave hundreds of dollars in annual premium savings on the table. In fact, according to a recent study by the Robert Wood Johnson Foundation, only about 10 percent of Medicare participants change plans annually1.

Keep in mind that deductibles, co-pays, and prescription drug coverage can change every year, so even if you didn’t change your plan this year, your plan may have changed on you. Staying put and not investigating your options could impact your yearly health care costs.

Here are a few tips to help you determine whether or not you have the best plan already, or if you should look in to available options:

1) Watch the calendar: In the past, Medicare gave you from Jan. 1 - March 31 to change your Medicare coverage. In 2011, those three months have been cut down to just six weeks, and the deadline to make a change in 2011 is Feb. 14, unless you qualify for a special election period.

2) Check it before you wreck it: Before you drop a Medicare Advantage plan, be sure the coverage you’re considering provides the benefits you need. Medicare Advantage often covers a portion of your doctor visits, as well as eye exams and other services. Also, make sure your doctor will accept the new coverage to which you’re switching.

3) Review your prescriptions: Compare the cost of a Medicare Part D prescription drug plan that covers your medications with the Medicare Advantage plan you’re currently on. It’s critical to make sure your monthly budget can handle the cost of drugs on your new plan versus your old plan. It’s easy and free to compare plans side-by-side on a website like PlanPrescriber.com.

4) Consider Medicare supplemental policies: Original Medicare has cost-sharing requirements and other benefit gaps, so some people who enroll in Original Medicare also purchase Medicare supplemental policies, also called Medigap. Medigap is offered through standardized plans, labeled A-N. Plans offered by different health insurers with the same letters offer the same benefits, but the costs can vary widely depending on age, community, inflation and other factors.

5) Don’t put off filling prescriptions: The drugs that are covered and how much they cost can change each year on a Medicare Advantage plan or Medicare Prescription Drug Plan. If you’re ordering 90-day supplies of medications to save money, or having them sent to you through the mail, be sure you see the bill for a new order placed in 2011 before Feb. 14. Don’t find out too late that one of the drugs you’re taking is no longer covered or that the co-pay has increased.

You may be able to get Extra Help to pay for your prescription drug premiums and costs. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or Your Medicaid Office (only required for pieces referencing Part D benefits or cost-sharing).

In general, beneficiaries must use network pharmacies to access their prescription drug benefit, except in non-routine circumstances, and quantity limitations and restrictions may apply.

1 RWJF-Funded Study Finds Medicare Part D Too Complex for Many Doctors: Published Jul 29, 2010

Ross Blair is president and CEO of Plan Prescriber, Inc. www.PlanPrescriber.com ), a leading provider of comparison tools and educational materials for Medicare-related insurance products. PlanPrescriber.com offers free and unbiased online advisor tools to help you find the optimal plan and save money.

Medicare has neither reviewed nor endorsed this information

Baby Boomer Women are Not Perfect

According to a new survey, baby boomer women have a clear and distinct advantage over the women of Generation Y. For those of you who don't know, baby boomer women were born between 1946 and 1964, while the women of Generation Y, also known as Millennials, were born between 1983 and 1997. The women in this group are the children from my generation.

Okay, so now that we have that straight here's what the survey says: Generation Y women are unable to master the chores their mothers and grandmothers did daily.

Only 51% of women under 30 can cook a roast, compared with 82% of baby boomers.

Traditional skills outside the kitchen are also slipping with only 23 percent of Generation Y women able to grow a plant and only 54% know how to sew.

I might add here that this survey was generated out of Australia by social researcher Mark McCrindle so it's very possible that those numbers would be even lower in the United States.

If the younger women don't have these skills, the question is why? Didn't their mothers pass on the knowledge that was passed on to them as they were growing up?

Amazing how some boomer women spend thousands of dollars for a perfect cosmetic look but fall short when it comes to teaching their own daughters a thing or two about life.

Silence May Be Hazardous to the Health of Boomer Women

A new survey indicates too many baby boomer women may be giving their doctors the silent treatment when it comes to talking about their health.

Although boomer women find themselves with increased personal health needs as they enter midlife and beyond, only 16 percent indicated they are likely to discuss those symptoms with a doctor, according to the new Boomer Women's Health survey of women aged 45 and older in North America sponsored by SCA, the maker of bladder protection products and services under the globally-leading TENA® brand (www.tena.us) and conducted by Harris Interactive.

The survey also revealed that over two-thirds of baby boomer women (67 percent) are less likely to see a physician if they think the symptoms they are experiencing are a "normal part of aging" and therefore may not seek solutions which can improve their quality of life. Furthermore, over a quarter (26 percent) feels uncomfortable, embarrassed or judged when discussing even common personal health issues with their doctors.

Women, however, aren't the only ones being quiet. The survey also demonstrated that doctors are not initiating conversations with women about these "sensitive" health topics either. Although bladder weakness and low sex drive were ranked as the top two most embarrassing topics to discuss with your doctor, they also ranked as the two issues that had been brought up the least by their physicians.

We, as women, owe it to our doctors to tell them what's going on.

You can read more about the lie I told my doctor that almost cost me my life in my new book, Don't Ask and I Won't Have to Lie available on Amazon.

The State of the Baby Boomer Union Address

I wonder how long it will be before the President of the United States will hold a live news conference to tell us the plight of the baby boomer generation. I imagine it will go something like this:

Good evening my fellow Americans. I come before you this evening to shed light on an epidemic that we have identified as a Silver Tsunami. We have known about this for quite some time but failed to act. As result of this tidal wave, we are facing the following disasters:

#1 As of January 1, 2011, 10,000 baby boomers will reach age 65 every day for the next 19 years.

#2 According to one recent survey, 36 percent of Americans say that they don’t contribute anything at all to retirement savings.

#3 35% of Americans already over the age of 65 rely almost entirely on Social Security payments alone.

#4 According to another recent survey, 24% of U.S. workers admit that they have postponed their planned retirement age at least once during the past year.

#5 Approximately 3 out of 4 Americans start claiming Social Security benefits the moment they are eligible at age 62. Most are doing this out of necessity. However, by claiming Social Security early they get locked in at a much lower amount than if they would have waited.

#6 The Healthcare System is overloaded as a result of all of the cosmetic surgery that is now catching up with the boomers.

Ladies and gentlemen, brace yourselves because this is just the tip of the iceburg. Good night and may God bless America and the baby boomers.