The Medicare open enrollment period closes at the end of December, and seniors, like everybody else, will be affected by newly implemented provisions of the health reform law. For starters, they will no longer have until the end of March to test a different Medicare plan and switch out if they find it unsatisfactory. Now, while they'll have until February 15 to try out a plan, they can change only if they decide to go from Medicare Advantage, which provides comprehensive healthcare coverage, to traditional Medicare, which covers hospital visits and has separate plans for doctor visits and drugs. This change may be a nuisance for the many beneficiaries whose Advantage plans have closed this year, forcing them to find new coverage.
The range of benefits seniors can expect will change, too; dental or vision coverage might go away, for example, to compensate for the long list of preventive services, such as colorectal cancer screenings and bone density testing, that insurers must now provide without co-pays or deductibles. Beneficiaries will be entitled to a free doctor visit to get a "personalized prevention plan" and a "comprehensive risk assessment." A government review board will determine by March what those terms mean, says Tricia Neuman, director of the Medicare Policy Project at the Kaiser Family Foundation.
Tweaks to the Medicare Part D drug coverage plan could result in a big cost saving for beneficiaries in 2011. Those with Part D coverage will pay a $310 yearly deductible and then 25 percent of the cost of their prescriptions until they've reached $2,840 in drug expenses for the year. After that, they must pay 50 percent of the cost of brand-name prescriptions until the total cost reaches $6,448, when their share drops to just 5 percent. That's a substantial change from 2010, when the entire bill in this "doughnut hole" was the patient's responsibility (minus a $250 rebate to help ease the pain). Oddly, coverage for generic drugs will be phased in more slowly over the next decade. In 2011, seniors will pay 93 percent of the cost of generics while in the doughnut hole; by 2020, just 25 percent.