How health care reform affects your Medicare enrollment

(ARA) - Health care legislation passed earlier this year may make Medicare annual enrollment season particularly challenging for the millions of baby boomers aging into Medicare and for seniors already enrolled who are considering different coverage for 2011. Annual enrollment runs from Nov. 15 to Dec. 31, allowing people to select their Medicare coverage for 2011.

"Choosing a Medicare plan can be overwhelming in any year," says Adrienne Muralidharan, senior Medicare specialist for the Allsup Medicare Advisor, a Medicare plan selection service for people with disabilities and those 65 and older. "However, this year there are not only the usual changes, such as premium and coverage changes, you also need to understand how the Patient Protection and Affordable Care Act may affect your 2011 Medicare coverage."

According to Muralidharan, the most important ways the new health care legislation will affect Medicare beneficiaries for 2011 include:

* Prescription drug costs should be lower in the "doughnut hole." For 2011, Medicare beneficiaries will receive a 50 percent discount for the cost of brand-name prescription drugs and a 7 percent discount for generic drugs they are taking while in the prescription drug doughnut hole.

* Medicare Part B (medical insurance) will fully cover preventive care. Beginning in 2011, Medicare beneficiaries will no longer have to pay deductibles or co-pays for preventive services that fall under U.S. Preventive Service Task Force guidelines, such as an annual wellness exam.

* More beneficiaries may have higher costs for Medicare Part B and Part D (prescription drug) coverage. The Part B income threshold freezes at the 2010 levels through 2019. As a result, individuals with modified adjusted gross income (income) exceeding $85,000 and married couples with income exceeding $170,000 will have to pay higher premiums. Because this will not adjust with inflation, it's likely more people over time will be subject to higher premiums. In addition, the law reduces the Medicare Part D premium subsidy for individuals with incomes above these levels.

* Opportunities to change coverage after the annual enrollment period will be more limited. Historically, an open enrollment period ran from Jan. 1 through March 31, immediately after annual enrollment ended. During open enrollment, people were able to switch from their existing Medicare plans to similar Medicare coverage, choosing from "like to like" options.

Now, open enrollment has been replaced with a shorter annual disenrollment period, which runs from Jan. 1 through Feb. 14. During this period, the only change that can be made is to disenroll from a Medicare Advantage plan in order to enroll in traditional Medicare and join a Medicare Part D plan. Other selections will not be available to consumers.

"It's easy to get confused over the various Medicare enrollment periods," Muralidharan says. "However, it's now more important than ever to look at annual enrollment as your main opportunity to choose your coverage."

Reasons to review your medicare coverage

Changes brought on by health care reform are just one reason people should evaluate their Medicare coverage. Each year, individuals with Medicare should consider different health care coverage if they experience any of the following:

* Your health situation has changed in the past year.

* Your provider situation has changed (for example, you hospital or physician left your plan).

* Your coverage has changed (for example, certain drugs, procedures or conditions are no longer covered).

* Your plan premiums and/or co-payments have increased.

* You have moved to a new location.

* Your current plan no longer will be available.

Additionally, people now turning 65 and becoming Medicare-eligible for the first time should carefully review their options - and make certain they follow the enrollment guidelines. Failing to do so can trigger costly penalties and may mean certain coverage is unavailable in the future.

"The choices you make about your Medicare coverage can have a significant effect on your health care and your finances," says Muralidharan. "If you are uncertain about which Medicare plans are available to you, or which would best meet your needs, seek help before enrolling." More information on Medicare plan selection assistance is available at Medicare.Allsup.com or (888) 271-1173.


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NAIC: Few Aware That Additional Health Care Reform Provisions Take Effect This Month

/PRNewswire/ -- Earlier this year, Congress passed sweeping reforms designed to revamp the health care system and increase access to care for many Americans. Yet, according to a new survey by the National Association of Insurance Commissioners (NAIC), many consumers are confused about the provisions and unsure of timing for actual implementation.

When asked to choose from four dates for which the first health care reform provisions officially take effect, only 14 percent correctly identified Sept. 23, 2010.

"Our survey findings are a clear indicator that most Americans are not aware of how soon some of the early health care changes may impact them," said NAIC President and West Virginia Insurance Commissioner Jane L. Cline. "It's essential for consumers to understand what to expect and when to consult their state insurance departments for more information."

When asked about specific reform provisions that take effect Sept. 23, most respondents correctly identified provisions concerning children. Specifically, 72 percent knew that children with pre-existing conditions may not be excluded from coverage and 70 percent understood that individuals up to age 26 may be covered under their parents' insurance.

However, half of the respondents were under the impression that employers with fewer than 50 employees will have to offer coverage to employees, and 47 percent incorrectly thought that all health insurance plans must cover approved preventive care and checkups without co-payment.

In reality, employers with fewer than 50 employees are not required by the new law to provide health insurance to staff, and all co-payments for preventive care and checkups are not eliminated. However, those qualifying for Medicare will receive new preventive care benefits that will include annual visits free of co-payments, but this is not mandated for all health insurance plans.

"The results show that while most consumers are well attuned to provisions specifically affecting their children's health care, they do not grasp the overall reform framework," said Cline. "It's promising to see this, but we feel it necessary for consumers to fully understand the changes and get informed about what to expect."

To keep up with the complex health reform process that includes multiple implementation phases in the coming years, the NAIC urges consumers to contact their state insurance department with questions. Go to http://map.naic.org/ to find your state contact information.

In addition, the NAIC website has a special section dedicated to health care reform questions and resources. Visit http://www.naic.org/index_health_reform_section.htm to learn more.

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Deloitte Survey: Majority of Insured Consumers Satisfied With Current Health Plan -- But Concerned About Changes Health Care Reform Act May Bring

/PRNewswire/ -- Of the 82 percent of consumers surveyed who consider themselves "well" or "adequately" insured, nearly all (96 percent) are somewhat or very satisfied with their health plans overall, according to a new Deloitte poll. (www.deloitte.com/us/consumerhealthpulse) Many are concerned the new health reform law will bring about significant changes to their current coverage. Of those enrolled in employer-sponsored health plans, 61 percent believe their employer will reduce benefits for dependents and retirees and 32 percent think employers will probably pay the penalty and discontinue health coverage for employees altogether.

"Anxiety about current and future health insurance coverage will continue to be a major issue for American consumers as health care reform is implemented nationally," stated Paul Keckley, Ph.D., executive director of the Deloitte Center for Health Solutions. "For example, our research shows that consumers who are covered through Medicare are more highly satisfied with their health care services than those in employer-sponsored plans."

Among survey respondents who consider themselves "very knowledgeable" about the Patient Protection and Affordable Care Act, many also indicated concerns over the impact of health reform on access to quality health care. They believe that some hospitals and medical practices will close (72 percent) and that their employers may drop their coverage (51 percent).

The cost of care is also an issue for the majority of consumers. Survey respondents anticipate increases in taxes (76 percent), health insurance costs, including premiums and out-of pocket expenses (65 percent), hospitals and physicians services (66 percent), and the cost of medications (54 percent) as reform is implemented.

Age is a major factor contributing to opinions about health care reform. In general, younger adults are more positive about health reform than older consumers. According to the survey, more than half (51 percent) of 18-34 year-olds believe that the reform bill will reduce health care costs in the long term, compared to respondents 45-54 years old (23 percent), 55-64 years old (36 percent), and 65 years old and above (30 percent).

"Younger consumers are beginning to embrace a new norm for health care," said Keckley. "Those in the younger age groups, (18-44 years old), are increasingly aware that the health care reform process has many moving parts and that they may find themselves entering into a new pact with employers."

The Deloitte survey also identified that consumers with employer-sponsored coverage seem to be the most skeptical and expect to experience negative impacts from the implementation of reform. This segment of survey respondents agree with the following:

-- The cost of the health reform act will be higher than expected (82
percent), which is significantly different from those who are
individually insured (68 percent).
-- The health reform act will not reduce health care costs in the
long-term (58 percent), which is significantly different from the
uninsured (43 percent).
-- Employers will pass the increased cost of health benefits through to
their employees (80 percent).


"Our research indicates that health insurance plans and employers may need to collaborate more than ever to help ease the anxiety of plan participants and employees as new health reform measures are implemented," said John T. Bigalke, vice chairman and Deloitte's health sciences and government industry leader.

Additional key findings from the survey include:

-- Eighty-four percent of all consumers surveyed have health insurance.
-- More than half (56 percent) of those surveyed believe that incentives
for doctors and hospitals to use electronic medical records will be
effective or very effective at improving the overall performance of
the health care system.
-- Cutting the rate of growth of Medicare costs will be only somewhat or
not effective at improving the overall performance of the health care
system according to 60 percent of those surveyed.
-- Sixty-nine percent of those surveyed believe the issue is not whether
an organization is for-profit or not-for-profit -- it's what they do
that matters.
-- Sixty-one percent of respondents agree that a mix of for-profit and
not-for-profit organizations stimulates positive competition and
innovation.

Methodology:


This survey was conducted via telephone interviews within the United States by Harris Interactive on behalf of the Deloitte Center for Health Solutions from May 21-24, 2010 among 1,019 adults ages 18 years old and above. Results were weighted to reflect the U.S. adult population. The survey results have a sampling error of +/- 3 percentage points at the 95% confidence level.

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