The Med Diva

An insider's guide to Medicare Part D and more

Archive for the category “Annual Notice of Changes (ANOC)”

Countdown to Medicare Part D Open Enrollment: Day 6

Open Enrollment for 2012 begins on Saturday, October 15, and ends on Wednesday, December 7, 2011.

Day 6: How to start weeding through all the Part D plan options

According to Q1Medicare.com, there will be 1,041 Medicare prescription drug plans (PDPs) in the United States in 2012. Although that’s 535 less plans than there were in 2010, 1,041 is still a large number, especially when you consider most beneficiaries can choose from 30 or more plans that cover their region.

Another issue that only adds to the confusion is the massive amount of advertising and marketing that private insurers do from October through December. As with any product, just because a plan advertises a lot or has an expensive-looking, slick brochure, it doesn’t mean that it’s the best plan for you. A magazine ad for Rolls Royce may look great, but if your income is limited or you are the chauffeur for lots of grandchildren, a Rolls is not practical.

2012 National Part D plan statistics: A real eye-opener

As with shopping for a new car or planning a big vacation, due diligence is critical when reviewing your Part D options.  I think you’ll agree with me when you consider just a few facts from Q1Medicare.com about all the Part D plans for 2012:

Average number of plans per region: 31
Number of plans with a $0 annual deductible: 488 (about 14 per region)
Number of plans with a monthly premium less than $25.00: 60
Lowest cost premium: $15.10
Highest cost premium: $131.80
Number of plans that provide any coverage in the Coverage Gap: 270
Lowest cost premium in a plan with any coverage in the Gap: $54.50

Start with the Medicare Plan Finder tool

Medicare’s Plan Finder tool is a great way to start weeding out your plan options for 2012. By entering your zip code, answering a couple questions about what type of Medicare coverage you have now and what kind of financial assistance, if any, you receive, you can start to narrow down the choices.  You can also refine your search by entering your drugs and your pharmacy, and by choosing limits on the monthly premium, annual deductible, coverage amount, etc.

For example, by doing a preliminary search, Plan Finder found 50 plans that were available to me. By narrowing down the search using my preferences on pricing and coverage, I got it down to 35 plans. That’s still a lot, but I did not use all the available filters so I’m sure I could have gotten it down even more if I spent a few more minutes fine-tuning my search.

I really can’t tout Plan Finder enough, and highly recommend it for every Medicare beneficiary. The best part is that it’s free, so even if you decide to get paid help from an insurance broker or counselor, you can bring a printout of the search results to your consultation to save some time. 

Tomorrow I’ll talk about some Part D marketing schemes that you need to watch out for in the coming weeks.

Countdown to Medicare Part D Open Enrollment: Day 13

Open Enrollment for 2012 begins on Saturday, October 15, and ends on Wednesday, December 7, 2011.

 Day 13: Ensuring that your plan still has you covered in 2012

If you are currently enrolled in a Medicare prescription drug plan, one of the first things you should do sooner than later is confirm that your current plan is going to continue covering your medications in 2012. You should also make sure that your drugs will be in the same cost-sharing tier next year.  If your plan is not going to cover one or more of your medications next year—or your drug is being moved to a higher cost-sharing tier (for example, it’s switching from a Tier 1 to a Tier 2 drug), you may want to shop around for a new plan during the Open Enrollment period.

Although Medicare requires all Part D plans to cover at least two drugs in each therapeutic drug category, each Medicare prescription drug plan has its own list of covered prescription drugs, which is called a formulary. Formularies include both generic drugs and brand-name drugs.

 Pay Special Attention to the Annual Notice of Change

All Part D plans can make changes to their formulary for the coming year, so you should never assume that your current plan will have you covered in 2012 just because it covers all your drugs this year. That’s why it’s critical to review your plan’s Annual Notice of Change, which you should have received by September 30.  

 Take a moment now to review the plan’s formulary, which should have been included in the Annual Notice of Change documentation. Ignoring the formulary now and not double-checking that your drugs will be covered  in 2012 could leave you stuck in a plan that may not be right for you—and may end up costing more than you should have to pay for your Medicare prescription drug benefit.

Countdown to Medicare Part D Open Enrollment: Day 16

Open Enrollment for 2012 begins on Saturday, October 15, and ends on Wednesday, December 7, 2011.

  Day 16: Let the Medicare Part D Marketing Begin

If you’re currently enrolled in a Medicare prescription drug plan (PDP), Medicare Advantage (MA) plan, or Medicare Advantage with Prescription Drug Coverage (MA-PD) plan, you should have already received your Annual Notice of Changes (ANOC) and Evidence of Coverage (EOC) documents. The Centers for Medicare & Medicaid Services requires plans to ensure that current members receive the ANOC/EOC by September 30, 2011. If you haven’t received your documents yet, call your plan immediately to make sure they have your correct address on file.   

The ANOC and EOC will tell you what your new monthly premium and annual deductible (if any) will be for 2012. They will also procide information about the drugs covered and the co-payments or coinsurance amounts that you will pay in each stage of your benefit.

Even if you are satisfied with your plan in 2011, you still need to review your plan options for 2012

It’s important to carefully review your ANOC and EOC as soon as possible to determine if you want to stay with your current plan or make changes for the coming year. All plan sponsors must contract on a yearly basis with the Medicare program, which permits changes to formulary lists (the list of drugs covered by the plan), restriction and limitation requirements, monthly premium payments, and co-payments or coinsurance. So, for example, if your plan no longer covers a drug that you take on a regular basis, or if the monthly premium has increased more than you expected, you may want to look for a plan that better meets your health and financial needs.

If you do decide that you need to change plans, remember you can only enroll in a plan or switch plans between October 15 and December 7.  After December 7, you will not be able to change yourMA,MA-PD, or PDP plan for 2012 unless you qualify for a Special Enrollment Period.

Starting October 1, 2011, plan information for 2012 will be available on the Medicare Plan Finder on Medicare’s website. MA and PDP plan sponsors can also start marketing their plans on October 1, so expect to get inundated with marketing materials over the next two months. Please keep in mind that Medicare plan sales agents can not do the following: 

  • Come to your house without an invitation from you
  • Approach you in parking lots, hallways, or lobbies
  • Offer you a gift worth more than $15 to join their plan
  • Provide free meals at Medicare sales presentations
  • Try to sell you a plan at educational events and seminars

Over the next few weeks I will be giving you lots of helpful tips, money-saving suggestions, and important things to consider when comparing Medicare Part D coverage.  I’ll also cover Special Enrollment Periods, Medicare star ratings, the Coverage Gap, and other Medicare topics that may not make a lot of sense to you right now, but are nonetheless important to understand in order to make the most of your benefit.

 

 

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