The Med Diva

An insider's guide to Medicare Part D and more

Archive for the category “Evidence of Coverage (EOC)”

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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