Now’s the time to review your Medicare coverage

QUICKREAD

Increasing Medicare coverage

• While Medicare currently covers 50 percent of mental health expenses, it will increase to 55 percent in 2010 and 2011; 65 percent in 2012; 80 percent in 2013 and thereafter.

Prescription drug plans

• Colorado had 53 prescription drug plans in 2009, but will have 48 in 2010.

• Monthly premiums range from $16.40 to $98.70 per month, but 86 percent of beneficiaries will see an average increase of $4.29 a month.

• The Part D deductible will increase to $310.

• The initial coverage limit is $2,830 and coverage gap or doughnut hole is $4,540.

• After spending $6,440 on out-of-pocket costs, a person will be eligible for catastrophic coverage, which pays 95 percent of costs.

Changes

• Starting Jan. 1, 2010, many more beneficiaries are eligible for Medicare Savings Program. Those include individuals who have a monthly income of less than $903, or $1,214 for couples with assets of $8,100 for an individual and $12,910 for couples.

• The Extra Help program, which provides assistance with paying for prescriptions, will be available for individuals with monthly incomes of $903 or less, or $1,214 per couple, and assets of less than $11,010 for individuals and $22,010 for couples.

• Numerous Medicare Advantage plans will increase premiums, some to more than $200 month, and decrease benefits in some areas, such dental care.

• More than 5,000 Colorado Medicare beneficiaries will lose coverage through their health plans, but these people will be allowed to enroll in a new Medicare Advantage plan or Medicare supplement plan in their area.

Seeking Assistance?

There is help for those trying to figure out how best to make Medicare insurance work for them.

For assistance, check out the government’s Web site http://www.Medicare.gov.

Basic information on Medicare plans can be found at http://www.eHealthMedicare.com.

For free Medicare counseling, contact the State Health Insurance Program at 1-888-696-7213 or, for Spanish, call 1-866-665-9668.

Help can also be found at 1-800-Medicare. To find local representatives by community, call 1-888-696-7213.



Colorado’s 574,263 Medicare beneficiaries would be wise to review their coverage this year and make changes, if necessary.

Each year, during the annual open enrollment period — Nov. 15 to Dec. 31 — beneficiaries are advised to review their options.

Medicare consumers who do not making changes by Dec. 31 automatically will be re-enrolled with the same coverage as 2009.

However, not heeding advice to view Medicare insurance options could be riskier than ever this year as insurers are cutting back on choices for Medicare Advantage and premiums for Part D prescription drug plans will rise.

According to the Kaiser Family Foundation, 185,673 people use Medicare Advantage in Colorado.

The foundation determined the average premium cost will rise by about a third for people who use Medicare Advantage and keep their current coverage. That increase does not include monthly premiums for basic Medicare coverage.

Basic Medicare premiums for higher-income Medicare consumers will rise by 15 percent in 2010, the foundation reported.

The average monthly premiums for Part D coverage will rise by 11 percent, but those costs vary widely according to plan and where consumers live.

Beneficiaries should consider a host of variables when reviewing health care options.

For example, physicians can change networks so it may be important to check if your primary care doctor is in your plan. People taking medications for chronic conditions should make sure those drugs are covered under their plan.

And it’s always wise to access long-term health care needs. If a surgery is planned for next year, make sure the procedure will be covered.


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