It's open enrollment -- the period each year when you can choose
or change your Medicare health and drug plans. You can enroll or
change plans from Oct. 15 until Dec. 7. Whatever changes you make
will take effect Jan. 1, 2013.
Medicare Advantage plans (also called Medicare Part C) are
offered by private insurers and cover Part A (hospital stays) and
Part B (doctor's visits). Most Medicare Advantage plans also
include drug coverage.
If you choose a Medicare Advantage plan, you can't buy a
Medicare supplemental insurance plan (known as Medigap) to pay for
your out-of-pocket costs. If the Medicare Advantage plan you choose
has drug coverage, you can't buy Part D drug coverage.
The federal government provides
an online brochure about Medigap insurance
Enrollment in Medicare Advantage to rise
More seniors than ever are expected to enroll in private
Medicare Advantage plans for next year. Health and Human Services
Secretary Kathleen Sebelius expects an 11 percent increase in
enrollment. But alarmingly, a new study from the Kaiser Family
Foundation found that one in four seniors
aren't even aware of open enrollment
The federal government expects the average Medicare Advantage
premium to increase only $1.47 over 2012. That would bring monthly
payments to an average of $32.59. The number of Medicare Advantage
plan choices is expected to increase by 7 percent next year.
When Medicare Advantage plan originally started as an
alternative to original Medicare, they were basically HMOs, which
require subscribers to have gatekeepers to treatment (primary care
physicians) to control costs, says Martin Rosen, co-founder of
Health Advocate Inc., of Plymouth Meeting, Pa., a company that
helps people navigate the health care system.
But Medicare Advantage plans have progressed. Today, Rosen says,
you can find an Medicare Advantage plan that's a preferred provider
Either way, with most Medicare Advantage plans you must use
providers -- doctors and hospitals - - that are in their networks,
says Rosen, co-author of "The Healthcare Survival Guide."
For some people that can be a disadvantage. The doctors you've
been seeing for years may not be in the network, he explains. You
may be able to go to a doctor outside the network, but you will pay
Also, Medicare Advantage plans are not available everywhere in
the country, says Elaine Wong Eakin, executive director of
California Health Advocates in Sacramento.
Steps before enrolling
Before you choose a Medicare Advantage plan, you should:
- Go online and find out which doctors and hospitals are in its
provider network. Call your doctors' offices to find out if they
take part in the Medicare Advantage plan you're considering. If
they don't, decide if you're willing to change doctors or
- Find out what happens if you go outside your coverage area.
If you spend the winter in a warmer climate, you may not want to
be limited by a Medicare Advantage network where you live during
the summer, Rosen says.
- If you take prescription drugs, check to see whether they are
on the plan's list of preferred drugs. If they aren't, you may be
better off with original Medicare and a Part D drug plan that
- Find out what your out-of-pocket expenses will be.
Deductibles, copays and co-insurance vary from plan to plan.
Compare costs to other Medicare Advantage plans and also to
original or basic Medicare and the supplements you would need.
Medicare.gov has tips on
things to think about when you compare Medicare
The best source of information on Medicare Advantage plans is
federal government's Medicare website
"Think of it as the yellow pages for Medicare and Medicare
Advantage plans," Eakin says. You can search for plans available in
your area by entering your zip code.
Once you've determined which plans are available in your area
and which you're interested in, reach out to them if you have
questions, Eakin recommends.
Do your homework, Rosen says. "It's really important to be an
educated consumer and make sure you're choosing something that's a
good fit for you and your circumstances."