New Deadlines for Medicare Choices

When is open enrollment for Medicare Advantage and Part D plans this year? Are the dates the same as they were last year?

No. There are some big changes to the open-enrollment schedule for Medicare Advantage and Medicare Part D this year, so you’ll need to make key decisions about your 2012 coverage several weeks earlier than in the past.

Starting this year, you’ll have from October 15 to December 7 to pick a Medicare Advantage plan (a private plan that provides medical and prescription-drug coverage) or a Medicare Part D prescription-drug plan for the coming year. (The open-enrollment period used to run from November 15 to December 31.)

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As a result of the new timeline, you’ll start receiving information about changes to your coverage and your plan options much sooner, too. In late September, your current plan must send you its Annual Notice of Change, which advises you of any alterations to plan benefits or premiums, or if the plan is being discontinued. “This is one piece of mail that you don’t want to throw away,” says Jan Berger, chief medical officer for Silverlink Communications, which provides consumer outreach for Medicare Advantage plans.

If you are currently enrolled in a Medicare Advantage plan, you need to be especially vigilant. Some smaller plans may consolidate and others may leave the business altogether because of changes in government subsidies and network rules. If your plan does close, you must pick a new Medicare Advantage plan by December 7 or your coverage will shift automatically to traditional Medicare on January 1, 2012. If that happens, you’ll need a separate Part D plan to provide prescription-drug coverage and a medigap policy to provide extra coverage for deductibles and co-payments. If, however, your Medicare Advantage plan continues to operate, you’ll be re-enrolled automatically in your current plan.

Even if you are satisfied with your current plan, it’s a good idea to review all of your options for next year’s coverage. Some plans will no doubt increase premiums and co-payments and make changes to their drug coverage. For example, your plan may switch some of the drugs you use to a more-expensive pricing tier. That potentially costly change may not be obvious unless you look up the drugs you use on the plan’s list, known as a “formulary.” Consequently, the plan that worked well for you in 2011 may not be the best deal in 2012, and some new plans may provide even better coverage.

Medicare Advantage and Part D plans can start marketing their 2012 plans on October 1. After that, you can use the Plan Finder tool at Medicare.gov to compare prices, co-pays, deductibles, coverage and drug tiers for all of the Part D and Medicare Advantage plans available in your area. (If you try to use the Plan Finder tool before October 1, it will not include 2012 information.)

Don’t just look at premiums; a plan with low premiums may have higher co-pays and cost you more in the long run. Instead, compare potential out-of-pocket costs of a Part D plan for the drugs you currently take. If you are considering an all-inclusive Medicare Advantage plan, look at the coverage, exclusions and out-of-pocket expenses for the type of medical care you tend to receive. See A Step-by-Step Guide to Comparing Your Medicare Options for more information about using the Plan Finder tool to pick the best plan for you. Or, you can get personalized assistance with your Medicare decisions through your local State Health Insurance Assistance Program (SHIP). To find local contact information, go to ShipTalk.org or call 800-Medicare (800-633-4227).

Finally, be sure to sign up for your 2012 plan by the new, December 7 deadline. “A lot of people procrastinate, and maybe Christmas was the time they’d talk to friends and family about their options,” says Berger. “This year, they have to back it up a holiday to Thanksgiving.”