October 25, 2011 09:00 ET
Six Things Medicare Beneficiaries and Baby Boomers Should Know About Medicare Advantage Plans: PlanPrescriber Releases List
MAYNARD, MA--(Marketwire - Oct 25, 2011) - Today PlanPrescriber ([ www.planprescriber.com ]), a wholly-owned subsidiary of eHealth, Inc. (
The [ Medicare AEP enrollment period ] opened on October 15, 2011 and runs through December 7, 2011. In most cases, Medicare beneficiaries who wish to make changes to their Medicare Advantage or Prescription Drug Plan selections for 2012 will only have an opportunity to make these changes during the AEP.
Medicare Advantage plans must provide the same level of health coverage provided by the government, but the plans are managed by private insurance companies that have been approved by the Centers for Medicare and Medicaid Services (CMS). Medicare Advantage plans must -- by law -- provide coverage equivalent to original Medicare -- Parts A & B. But, most MA plans offer additional benefits and also include Medicare Part D prescription drug coverage.
Here is a short list of the six things people who are new to Medicare should remember about Medicare Advantage plans:
1. One bill: Because most Medicare Advantage plans include prescription drug coverage, people don't have to write two checks -- one for the drug coverage premium and one for the medical coverage premium -- to two different companies.
2. Affordable monthly premiums: Some Medicare Advantage plans are available at no additional monthly premium to original Medicare (Parts A&B). According to the Kaiser Family Foundation, the average monthly premium was $431 for a Medicare Advantage plan in 2011, and the US Department of Health and Human Services has indicated that Medicare Advantage premiums will decrease by 4 percent in 20122.
3. Out-of-pocket limits: The affordable care act requires all Medicare Advantage plans to have a limit on how much a customer can pay out of their own pocket excluding the cost of prescription medications. The maximum limit for out-of-pocket expenses allowed by health reform is $6,700. By comparison, original Medicare does not have an out-of-pocket limit.
4. Additional Benefits: Medicare Advantage plans often cover things like routine vision and routine dental care, as well as additional benefits like audiology services and fitness classes. And many plans include the Medicare Part D prescription drug benefit.
5. Flexibility: With a Medicare Advantage plan, beneficiaries have the option to change their plan each year during the Annual Enrollment Period. There may be additional opportunities to change coverage throughout the year based on individual circumstances. For example, in 2012, anyone with access to a Medicare Advantage plan with a "5 Star" rating will be able to enroll in that plan at any time throughout the year.
6. Variable Plan Types: In the past, Medicare Advantage plans were often available primarily as HMO plans where services were provided through a specific network of doctors and hospitals that often required referrals to see specialist. Medicare Advantage plans are becoming increasingly available as; Preferred Provider Organizations (PPOs), which offer a wider choice of providers; Private Fee-for-Service (PFFS) plans that don't typically have networks; and Special Needs Plans (SNPs) specifically designed for people with lower incomes and/or specific diseases or conditions.
Sources
1Kaiser Family Foundation: [ http://www.kff.org/medicare/upload/8117.pdf ]
2The US Department of Health and Human Services: [ http://www.hhs.gov/news/press/2011pres/09/20110915a.html ]
About PlanPrescriber.com
PlanPrescriber ([ www.planprescriber.com ]), a wholly-owned subsidiary of eHealth, Inc., is a leading provider of comparison tools and educational materials for Medicare Advantage, Medicare Part D Prescription Drug Plans, and Medicare Supplement insurance products. Medicare beneficiaries can take advantage of PlanPrescriber's no cost, no obligation online advisor tools by logging on to [ www.PlanPrescriber.com ]. PlanPrescriber is a tool designed to help Medicare recipients find a Medicare plan that covers their specific medical and prescription drug needs at the lowest possible out-of-pocket cost.
About eHealth
eHealth, Inc. (
For more news and information about health insurance, health reform and Medicare, visit eHealth's consumer blog: [ Get Smart - Get Covered ].
Medicare has neither reviewed nor endorsed this information.