Medicare Advantage in 2011

Changes to Medicare Advantage Plan Options

Every year, Medicare Advantage (Part C) plans undergo changes that may or may not affect your coverage. This year, many of the changes in Medicare Advantage plans deal with recent health care legislation. The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 were signed into law on March 23, 2010 and March 30, 2010. The changes that have been made to Medicare Advantage in 2011 will have the greatest effect on low-income individuals.

Price Freeze on Premiums for Medicare Part C in 2011

In an effort to bring Part C premiums closer to the average costs of Medicare beneficiaries, recent health care legislation has placed a freeze on premium increases. This means that your Medicare Part C premiums cannot increase in 2011. Between 2012 and 2013, your premiums will gradually decrease so that eventually your out-of-pocket costs will be closer to that of enrollees in traditional Medicare.

Additionally, private insurers offering Medicare Part C in 2011 will not be allowed to have higher cost-sharing (coinsurance, copayments, deductibles) requirements than traditional Medicare for certain services. Medicare Advantage plans that provide benefits not offered by Original Medicare (Part A) must prioritize the reduction of out-of-pocket costs, preventive care coverage, providing wellness programs and preventive care.

Enrollment Dates for Medicare Advantage in 2011

Whether you're already enrolled in Medicare Part C or you are signing up for the first time, you should take note of the new enrollment dates for Medicare Advantage in 2011. Beginning in 2011, the annual election period (the period when you can submit the application to change your Part C plan) will be from October 15 to December 7 of each year. Changes made during this period will take effect on January 1 of the following year. Another change to Medicare Advantage in 2011 is the new period during which you may switch from Medicare Advantage to Original Medicare. This period begins January 1 of each year and lasts 45 days.

The Special Needs Program Extended until 2014

People with certain diseases or disabling conditions (such as HIV/AIDS, diabetes, congestive heart failure, a mental health condition) or who live in an institution (like a nursing home) can join the Special Needs Program (SNP). One of the recent changes in Medicare Advantage includes the extension of the SNP until 2014.

Some Private Insurers may be Dropping Medicare Advantage in 2011

Some private fee-for-service plans that let you use any doctor or hospital and are subject to new network requirements may be dropping Medicare Advantage plans from their offerings in 2011. If you are affected by these changes, you should have received a notice of cancellation by October 31, 2010. Your coverage will automatically switch to Original Medicare unless you elect to switch to another Medicare Advantage plan. It is important to review all of your options before making a decision, as you may want to enroll in a Medigap plan or a Medicare Part D plan if you choose to keep your Original Medicare plan.