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A Season For Medicare Choices

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Ron Pollack, Families USA Executive Director

Posted Oct. 1, 2012, 2:11 am

Special To The Mirror

By Ron Pollack

Families USA Executive Director

As the weather turns cooler, it’s time once again to think about your Medicare choices. Unlike the past several years, there are relatively few changes to Medicare rules for 2013.

But because your individual plan or your circumstances might be changing, you should still take a close look at your coverage options.

There’s also another choice ahead this November: it has to do with the future of Medicare, and health care, for all of us.

The major Medicare changes that were part of the health care law remain in place. Like last year, the annual enrollment period is earlier than it used to be: It will run from October 15 to December 7, so don’t plan to wait until the end of December to make a change.

Prescription drug coverage continues to improve: When people fall into the proverbial doughnut hole, they will continue to receive even better discounts on their prescription drugs than for 2012. Many preventive services are now free for everyone with Medicare.

It’s always a good idea to review the coverage you have.

If you have a Part D prescription drug plan or a Medicare Advantage plan, you should receive a letter from your plan called an “Annual Notice of Change” that informs you how your plan will be changing next year.

Check to see what’s happening with premiums and copayments. Take a look at coverage for particular drugs or services.

Make sure your doctors, pharmacies, and other providers will still take the plan.

Remember a few key tips:

• If you have original Medicare and a supplemental plan (sometimes called Medigap), you don’t need to change. Be very careful if you do decide to drop your Medigap plan – you may not be able to get it back later. Each state has its own rules about purchasing Medigap plans.

• Don’t believe any high-pressure sales pitches. Do your homework and make an informed decision.

• Get help if you need it. The Medicare.gov website lists all the plans in your area. You can call 1-800-MEDICARE for general information and to enroll in a plan. You can also get a referral for your local State Health Insurance Assistance Program (SHIP). Every state has one, and they provide free counseling and advice to everyone with Medicare.

• If you or someone you know has limited income and resources, you may qualify for additional help. Talk to your local SHIP, or go to the Social Security website: www.ssa.gov/prescriptionhelp.

• If you do decide to enroll in a new plan, do it through 1-800-MEDICARE, rather than through the plan itself.

Our nation as a whole will also make a very big choice this November about Medicare and the future of health care.

One path is laid out in the health care law that builds on the existing Medicare system.

It aims to slow down health care costs over time without pushing new costs onto individuals.

The other path was laid out last spring in the House of Representatives’ proposed budget. It would repeal the health care law, including the improvements in Medicare prescription drugs and preventive care coverage.

It would also transform Medicare into something very different than we have today, by giving private insurance companies much greater control over seniors’ health care coverage.

Most experts have concluded this will result in increased out-of-pocket costs for seniors who rely on the program now, and even higher costs for future generations.

Whatever you think of these two paths, we can all agree they are very different. Just as you shouldn’t rely on a sales pitch to make a choice about your Medicare plan for next year, you shouldn’t rely on the rhetoric from either side when you decide how to cast your vote.

Do your research and make up your own mind. Being an informed consumer – and an informed voter – is the best way to protect yourself for next year, and for years to come.

Families USA is the national organization for health care consumers. They have advocated for universal, affordable, quality health care since 1982. Ron Pollack is the Executive Director of Families USA.