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How is Your Medicare Part D Prescription Drug Plan Changing in 2012?

Category: Annual Medicare plan changes
Published: Nov, 08 2011 03:11:58


Many people do not change their Medicare Part D or Medicare Advantage plan each year, even when they may be able to save money on their prescription and medical costs.  If you decide to stay with your current Medicare plan coverage, please remember that Medicare Part D prescription drug plan and Medicare Advantage plan costs and coverage details can change every year -- so be prepared for the changes to your current plan in 2012.

How could your Medicare Part D prescription drug plan change in 2012?  You may see changes in:
  • Monthly Medicare prescription drug plan premiums
  • The amount of your plan’s initial deductible (that is, the amount you pay before coverage)
  • Your plan’s Initial Coverage Limit (when you enter the Donut Hole or Coverage Gap)
  • Your Donut Hole or Coverage Gap benefits (whether your plan pays anything in the Gap)
  • Your plan’s drug cost-sharing design (co-payments and co-insurance)
  • Medications covered on your plan’s formulary or drug list
  • $0 premium Low-Income Subsidy status (plans may no longer qualify for the $0 premium)
  • Your plan’s Medicare “Star” or quality rating
Bottom Line:  If you do not enroll into a new Medicare Part D plan or Medicare Advantage plan, you will be automatically re-enrolled into your current Medicare Part D or Medicare Advantage plan for 2012 and your 2012 Medicare plan may cost you more money and provide different coverage than in 2011.  The good news is that you still have plenty of time to review your 2012 Medicare plan coverage options.

How to learn more about the changes in your 2012 Medicare plan?
Your Medicare plan provider is required to summarize any 2012 plan changes in your Annual Notice of Change letter (or ANOC) that you should have received in late-September.  We heard from some people who had not received or recognized this ANOC letter and never learned about their 2012 Medicare plan changes.  If you have not received a copy of your plan’s ANOC letter, please call your plan’s Member Services department and ask your plan to send another copy of your ANOC.

Please note that the information you receive in your ANOC letter may at first seem a little overwhelming.  Your ANOC letter alone is probably around 10 pages long, plus in this same mailing is your Medicare plan’s 2012 Evidence of Coverage (or EOC) document, making your ANOC letter look as if it is well over 100 pages long.  Some plans may even break the ANOC letter mailings into several pieces (for instance, the mailing might be marked “Part 1 of 2”).  Together, the ANOC letter and the EOC document will provide you with a great deal of detailed information on your 2012 Medicare plan coverage.

Need a quicker way to see some of the changes in your Medicare Part D plan?
We have our 2011/2012 PDP-Compare tool online to help you see how your current 2011 stand-alone Medicare Part D prescription drug plan coverage is changing in 2012.  Our PDP-Compare tool allows you to compare changes in all stand-alone Medicare Part D prescription drug plans (or PDPs) across the country.  The 2011/2012 PDP-Compare shows monthly premium and plan design changes, as well as changes in your co-payments or co-insurance rates for different drug tiers.  PDP-Compare will also show you the Medicare Part D plans that will be discontinued or added in 2012.

To get started, simply go to PDP-Compare.com and click on your state.

A few tips for more advanced users of our PDP-Compare tool:
  • If you wish to narrow the search by the name of your prescription drug plan, just choose the name of your Medicare Part D plan family (such as “AARP” for all “AARP MedicareRx” plans) and then click the “Click to Compare Annual Plan Changes” button.
  • If you want to search for Medicare Part D plans with specific features, such as only those plans qualifying for the $0 premium full Low-Income Subsidy, you can select “Yes, show only plans that qualify for $0 premium” for the “Full Low-Income Subsidy?” question in the search-form.  Click here for an example of the 2011 $0 Premium LIS plans in Texas.  You can then see which of those plans still qualify in 2012. Additional examples of Part D plan changes are provided in the next section below.
  • If you want a little more help, our PDP-Compare tutorial will show you a few screen shots and provide tips on how to see the changes in your current Medicare Part D plan.
Still not sure where to begin or you have a question?  Click here to let us know.








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  • The benefit information provided is a brief summary, not a complete description of benefits. For more information contact the plan.
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    Statement required by Medicare:
    "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE to get information on all of your options."
  • When enrolling in a Medicare Advantage plan, you must continue to pay your Medicare Part B premium.
  • Medicare beneficiaries with higher incomes may be required to pay both a Medicare Part B and Medicare Part D Income Related Monthly Adjustment Amount (IRMAA). Read more on IRMAA.
  • Medicare Advantage plans that include prescription drug coverage (MAPDs) are considered Medicare Part D plans and members with higher incomes may be subject to the Medicare Part D Income Related Monthly Adjustment Amount (IRMAA), just as members in stand-alone Part D plans. In certain situations, you can appeal IRMAA.
  • You must be enrolled in both Medicare Part A and Part B to enroll in a Medicare Advantage plan. Members may enroll in a Medicare Advantage plan only during specific times of the year. Contact the Medicare plan for more information.
  • If you are enrolled in a Medicare plan with Part D prescription drug coverage, you may be eligible for financial Extra Help to assist with the payment of your prescription drug premiums and drug purchases. To see if you qualify for Extra Help, call: 1-800-MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. TTY users should call, 1-800-325-0778; or your state Medicaid Office.
  • Medicare evaluates plans based on a 5-Star rating system. Star Ratings are calculated each year and may change from one year to the next.
  • A Medicare Advantage Private Fee-for-Service plan (PFFS) is not a Medicare supplement plan. Providers who do not contract with the plan are not required to see you except in an emergency.
  • Disclaimer for Institutional Special Needs Plan (SNP): This plan is available to anyone with Medicare who meets the Skilled Nursing Facility (SNF) level of care and resides in a nursing home.
  • Disclaimer for Dual Eligible (Medicare/Medicaid) Special Needs Plan (SNP): This plan is available to anyone who has both Medical Assistance from the State and Medicare. Premiums, co-pays, co-insurance, and deductibles may vary based on the level of Extra Help you receive. Please contact the plan for further details.
  • Disclaimer for Chronic Condition Special Needs Plan (SNP): This plan is available to anyone with Medicare who has been diagnosed with the plan specific Chronic Condition.
  • Medicare MSA Plans combine a high deductible Medicare Advantage Plan and a trust or custodial savings account (as defined and/or approved by the IRS). The plan deposits money from Medicare into the account. You can use this money to pay for your health care costs, but only Medicare-covered expenses count toward your deductible. The amount deposited is usually less than your deductible amount, so you generally have to pay out-of-pocket before your coverage begins.
  • Medicare MSA Plans do not cover prescription drugs. If you join a Medicare MSA Plan, you can also join any separate (stand-alone) Medicare Part D prescription drug plan
  • There are additional restrictions to join an MSA plan, and enrollment is generally for a full calendar year unless you meet certain exceptions. Those who disenroll during the calendar year will owe a portion of the account deposit back to the plan. Contact the plan provider for additional information.
  • Medicare beneficiaries may enroll through the CMS Medicare Online Enrollment Center located at www.medicare.gov.
  • Medicare beneficiaries can file a complaint with the Centers for Medicare & Medicaid Services by calling 1-800-MEDICARE 24 hours a day/7 days or using the medicare.gov site. Beneficiaries can appoint a representative by submitting CMS Form-1696.