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Medicare Open Enrollment Began Monday

By Brandon Moseley
Alabama Political Reporter

Friday Health and Human Services Secretary Kathleen Sebelius announced in a written statement that people with Medicare have more choices and the performance of Medicare Advantage plans are improving.  Sec. Sebelius’s statement was released on the eve of the start of the annual Medicare Open Enrollment period which began Monday.

Annual Medicare open enrollment began on Monday, October 15th and will continue till December 7th.  During the annual Open Enrollment Period Medicare beneficiaries are allowed to change their prescription drug benefits or enroll in a Medicare Advantage plan.  The federal government allows beneficiaries to change their benefits only in the open enrollment period.  Any changes made during the open enrollment period go into effect on January 1, 2013.

Sec. Sebelius said, “In 2013, people with Medicare will have access to a wide range of plan choices, including more four and five star plans than ever before.”

Several changes to Medicare will take effect in 2013.  Medicare Part D participants who reach the so-called doughnut hole coverage gap will begin receiving a 52.5 percent discount on brand-name prescription drugs and a 21 percent discount on generics, compared to 2012′s 50%/14% rates.  Medicare will begin covering additional preventive and screening services.  These include assessments and counseling for depression, alcohol misuse, cardiovascular disease and obesity.

According to Sec. Sebelius, Medicare beneficiaries will have access to 127 four- or five-star Medicare Advantage plans. In 2013 37% of Medicare Advantage enrollees will have access to these highly rated plans.  In 2012 only 106 plans had access to four and five star plans and only 28% of enrollees had access to these plans.

Plan access varies by county.  Not every Medicare Advantage plan in Alabama operates in every county in Alabama.  Medicare rates plans on a 1 to 5 star scale.  1 star represents poor performance, while 5 stars represent excellent performance.  The top rated 5-star plans receive a gold star.

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Medicare Advantage (also called Medicare Part C) offers plans run by Medicare-approved private insurers as alternatives to Original Medicare. Many also cover prescription drugs and some will include extra benefits usually at additional cost. You’re usually required to use the plan’s provider network.

Medicare beneficiaries can also opt to remain in the Original Medicare program.  Most Original Medicare enrollees elect to purchase a Medicare Supplement Insurance Policy (also called Medigap insurance) that pays all or most of what Original Medicare does not pay.

Medicare beneficiaries will also have access to 26 four or five star prescription drug plans.  These high rates plans currently serve 18% percent of Medicare Prescription Drug Plan enrollees.  In 2012, there were only 13 four or five star plans serving just 9 % of enrollees.


Brandon Moseley is a former reporter at the Alabama Political Reporter.

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