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What’s new about Medicare in 2012

By Jennie L. Phipps ·
Wednesday, October 12, 2011
Posted: 9 am ET

Here's more about Medicare Open Enrollment, which starts Saturday, Oct. 15 and ends Dec. 7 -- earlier than it has in previous years.

Figuring out how to manage health care costs is a key part of retirement planning. Here are some of the things the Medicare Rights Center advises that you do:

  • Read your Annual Notice of Change, which you should have received by now. It will list the changes in your plan, such as premium and co-pays, and compare the benefits in 2012 with those in 2011.
  • Check the cost of your Part D prescription drug plan premium. The average cost is about $30, about the same as this year. If you are paying more, you might be paying too much, and who can afford to do that in retirement?
  • Part D formularies (lists of covered drugs) often change from year to year. Drugs and restrictions can be removed or added. Check your plan’s new formulary to see how the drugs you take will be affected. This is very important. A drug that your doctor prescribes that isn't covered could cost you a lot of money.

Here are some things that the Medicare Rights Center says are different this year:

  • There will be a 50 percent discount for brand-name drugs during the doughnut hole -- same as this year -- but the discount for generics during the doughnut hole will increase to 14 percent.
  • Starting in 2012, Medicare Advantage plans will not be able to charge enrollees for preventive care services that are free for people with Original Medicare, but if you go to a doctor who is out of your network, charges will apply.
  • Starting in 2012, people with Medicare will have a Special Enrollment Period, or SEP, to enroll in a Medicare Advantage or a Part D plan with a five-star rating (on a scale of one to five). The special enrollment plan can be activated at any time during the year, but only once per year, and to make only one change. This could be inconvenient. For example, a consumer in a Medicare Advantage plan with a built-in prescription drug plan who enrolls in a five-star Medicare Advantage plan without drug coverage would not be able to join a prescription drug plan until the next fall open enrollment period, and would have to go without drug coverage until then.
  • The Medicare Advantage Disenrollment Period runs from Jan. 1 to Feb. 14. During this period, people who are unhappy with their Medicare Advantage plan are allowed to switch to Original Medicare, and also may add Medicare prescription drug coverage, even if their Medicare Advantage plan did not include drug coverage. People in Medicare Advantage plans cannot switch to another Medicare Advantage plan. People with Original Medicare cannot make any changes. There is one exception, you can enroll in a five-star MA or Part D plan at any point during the year, including during the Medicare Advantage Disenrollment Period.

Confused yet?

Tomorrow we'll talk about what to ask if you're considering a Medicare Advantage Plan.

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Mesa Best
October 21, 2011 at 8:02 pm

I do not know about 30% less for 2012. What I do know for sure is that the plan you choice you should reveiw the summary of benefits. You will need to check the cost of benefits for Original Medicare; Medicare Supplement; and Medicare Advantage. You do not want a penalty 1% and 10%, if you do not pick up the secondary insurance up on time. If you need more details call me at 908-215-5143. I will be glad to go over some issues, you may have.

Beverly P. Jahnke
October 14, 2011 at 3:15 am

I thought I hear on television that starting in 2012, Medicare will pay doctors 30% less then they do now. Is this true? If this is true, why would any doctor want to work with people who are on Medicare?

Please let me know. We just signed up with my husbands former employer regarding our health insurance for next year. If Medicare is going to reduce by 30%, we may decide to go off of Medicare!!


Beverly P. Jahnke