Medicare's open enrollment season ends on Dec. 31 and the popular government-run healthcare system is reminding members that now is the time to enroll, re-enroll or change their Medicare Part D, or prescription drug plan, for 2011.
Many people are taking action now with the assistance of our partners across the country, with support from family, friends, caregivers and trusted representatives, using the telephone, face-to-face and web-based resources to make the most of their Medicare in 2011, said Health and Human Services Secretary Kathleen Sebelius. And people with Medicare should be aware of new benefits provided under the Affordable Care Act next year, including recommended preventive health services without cost-sharing, and discounts on covered brand-name prescription drugs in the Medicare prescription drug coverage donut hole.
The donut hole is the notorious gap in coverage established when Medicare began offering the prescription drug benefit in 2006. After an annual deductible of $310, the beneficiary pays about 25 percent of prescription costs from $310 to $2,840. Then the beneficiary falls into the donut hole where, until the Affordable Care Act, which became law this year, the beneficiary was responsible for all costs from $2,840 to $6,448. After $6,448, coverage begins again.
The ACA began to close the donut hole this year with a $250 rebate check. In 2011, beneficiaries in the donut hole can buy brand-name drugs at half-price and receive a lesser discount on generics. By 2020, the donut hole will be closed, and beneficiaries will have a 25 percent co-pay.
There are numerous drug plans available under Medicare Part D and the beneficiary has to choose one. Senior advocates, like AARP and Families USA, as well as community-based programs throughout the nation assist seniors in choosing an appropriate plan. Medicare offers counseling through 1-800-MEDICARE and www.medicare.gov.
We continue to urge all people with Medicare to focus on Open Enrollment, and, if they need help understanding their options, be aware that they can get help locally in their home communities or seek assistance from state-based senior health advocates, Sibelius said. These community partners can help people use the tools on www.medicare.gov that let people compare costs and coverage and find prescription drug and health plan options that best fit their needs for 2011.
After comparing plans, if beneficiaries are satisfied with their current plan's benefits in 2011, they don't need to do anything. If another option will provide a better match for their needs, there is still time to change, Medicare officials said.
More information is available at www.HealthCare.gov, a new web portal made available by the U.S. Department of Health and Human Services.