By Colleen Van Horn, RN, B.S.N., PHN, CCM
This year, the Medicare “open enrollment” period began on October 15, and will continue to run through December 7 -- constituting a window that falls much earlier than usual, and which subsequently threatens to leave some seniors and their caregivers unprepared. According to
, those who rely upon Medicare for health benefits and prescription drugs should be aware not only of the bumped-up enrollment period, but also of other changes to the open season that will impact the breadth and quality of benefits to which members are entitled.
In addition to restructuring the timeframe for enrollment (during which existing members can also change prescriptions and health plans), Medicare is also initiating a quality rating system this year, as well as implementing reforms to the program’s infamous gaps in prescription drug coverage. According to
editor Nancy Metcalf, the rating system is “star-based,” with 4 or 5 star-rated health plans constituting those with the most funding as a reward for superior service. Members who can choose a 4 or 5-star plan will receive more benefits; but for those on lower-rated plans, there are still some new, guaranteed benefits across the board that seniors can look forward to in the coming year.
Moving forward, both Medicare and Medicare Advantage plans will include a selection of free preventative benefits, such as annual check-ups and certain screenings for diseases like heart disease and cancer. What’s more, those individuals who currently face a gap in their drug coverage benefits will receive automatic, compensatory discounts to help alleviate the burden of cost. Members who find themselves paying Medicare premiums without the benefit of drug coverage will receive a 50 percent discount on brand-name medications, and a 14 percent reduction for generic drugs.
Smart planning and custom advice for future healthcare security
Even when they promise some new advantages, changes to the Medicare system can be challenging for some seniors and their caregivers. For those interested in budgeting information, the Medicare plan finder website offers a spreadsheet feature that will help members determine month-to-month out-of-pocket prescription costs. In addition, the
webpage offers further
concerning the Medicare changes for 2012.
As experience geriatric care managers and committed healthcare advocates, we at
encourage seniors to research their Medicare options and seek help and advice from skilled professionals in order to determine the best possible path to comprehensive and secure medical care. Planning for the future can be intimidating – and that’s why our skilled and compassionate care managers are here to help. For more information about elder care planning, visit us online: