MANATEE -- The open enrollment period for Medicare drug and health plans starts Saturday, and if that seems early, that’s because it is.
The Oct. 15 opening is two weeks earlier than the usual Nov. 1, and it closes earlier, on Dec. 7.
Insurers’ marketing efforts have most people aware of the early start, said Joe Baker, president of the Medicare Rights Center, a national advocacy group. “Our only concern is that people won’t notice that it doesn’t close at the end of the year,” he said.
But there’s a good reason for moving up the closing date, he and other Medicare advocates say.
“This removes it from the holidays,” said Gudrun Bennett, the Manatee County coordinator for Florida SHINE, a division of the state Department of Elder Affairs.
The busy season often deters seniors from reviewing their plans until the last minute, said Jim Larkin, a volunteer counselor with Associated Medicare Patients, a nonprofit group based in Venice.
Then they often hit red tape at their doctor’s office in January: “Their paperwork wasn’t caught up,” Larkin said.
Overall, there are few big changes to the Medicare plans offered by private insurers, despite concerns voiced during the health care reform debate.
“Everyone expected the Affordable Care Act to decimate the marketplace,” Baker said. “The doomsayers have been proven to be wrong.”
Changes to how the government pays private insurers to offer the plans started with this year, and the average premium actually has dropped, Baker said.
A review by the Herald found that Manatee residents can choose from 33 prescription drug plans, 26 Medicare Advantage health plans with drug coverage and eight Medicare advantage plans without drug coverage.
That’s virtually unchanged from last year when there were 32 drug plans, 29 Advantage plans with drug coverage and eight without drug coverage.
Costs also appear to be about the same. Florida officials said Medicare Advantage health plan premiums actually will fall an average of 4 percent in 2012 compared to 2011, while drug plan costs were essentially unchanged.
Premiums for prescription drug plans in Manatee range from $15.10 to $125 a month. Last year, the range was $14.80 to $119.70.
But the advocates warn that their usual message remains the same: Even if you love your plan, look it over carefully.
“Unfortunately, there are quite a few people who think that once they signed with a plan, they’re going to stay with it,” Bennett said. “And that doesn’t work well, especially with the prescription drug plans.”
The plans often drop medications from one year to the next, and people need to make sure the plan still pays for what they need. Otherwise, they will have to pay out of pocket, Larkin said.
Similarly, a Medicare Advantage health plan may add or drop certain doctors, and different plans have different networks of physicians.
“If you change a health plan, you may have to change a doctor too,” Bennett said.
Below are suggestions and questions to consider during the enrollment period, from the Medicare Rights Center, Florida SHINE and Associated Medicare Patients:
n If you already are enrolled in a Medicare health or drug plan, start by reviewing a document called the Annual Notice of Change, which the insurer should have sent by Sept. 30.
n Make sure the plan accepts your current doctor, if you want to stay with that practice.
n If you would change to a doctor in the plan, check to see if the doctor is accepting new patients.
n Check to see what specialists, home health plans and nursing homes are in the plan’s contract. Review what it will cost to see both a primary doctor and a specialist.
n For drug plans, review the plan’s formulary, the list of medications it covers, and be sure yours are listed. Before enrolling, call the plan to be sure the list is accurate.
n Consumers also should look beyond the bottom line. A plan might have a low premium, but it might restrict services or have other charges. “We always counsel that you should look at cost but it should not be the sole thing you look at,” Larkin said.
n When you enroll in a plan do so by calling (800) MEDICARE rather than calling an insurer or using its website. The Medicare program has good reliability, records calls and keeps good records, which is important if there is a problem later. “It provides an extra layer of protection for consumers,” Baker said.
n Two benefits from the Affordable Care Act remain in place. There will be a 50 percent discount on the out-of-pocket cost of medications in the “doughnut hole” period, and the discount on generic increased to 14 percent.
n People eligible for Medicare can make as many changes as they want before the end of open enrollment.
n There is one important change to the “disenrollment” period, which runs from Jan. 1 to Feb. 14. As before, people with Advantage plans can switch back to traditional Medicare. Starting this year, they also can switch to a different Advantage plan if the new plan has a five-star rating.