WHAT THE NEW HEALTH BILL SHOULD MEAN FOR MEDICARE

Obama calls for $250 payment to Seniors in 2010

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October 15, 2009   The Obama administration is pursuing a different way to boost recipients' income. On Wednesday, President Barack Obama called for a second round of $250 stimulus payments for seniors, veterans, retired railroad workers and people with disabilities.

The payments would match the ones issued to seniors earlier this year as part of the government's economic recovery package. The payments would be equal to about a 2 percent increase for the average Social Security recipient.

      For much more helpful information on Medicare, Parts A, B, C, and D, the Donut Hole, the CPI-W, Current Medicare News Articles, and much more, see our Medicare Page.

THIS IS THE SENIORARK MEDICARE BIG RED NEWS BOX

(Your source for the latest Medicare information, as you make decisions for 2010)

---TIME TO DECIDE  ON PART "D" AND "MEDICARE ADVANTAGE"

THESE MUST BE RECONSIDERED EVERY YEAR AT THIS TIME

     Friday November 06, 2009   Now Is the time to decide on a Medicare plan. Prices for both Medicare Part D prescription-drug plans as well as Medicare Advantage plans are going to rise in 2010. And you have from Nov. 15 to Dec. 31 to decide whether you want to stay in the same plan or switch plans for 2010. Average premiums for Part D plans are increasing 7 percent in 2010, and average premiums for Medicare Advantage plans are jumping 22 percent. These price hikes may be particularly tough to deal with next year, since Social Security will not have a cost-of-living increase.

Here are some of the changes to watch for:

• For 2010, more than 60 percent of Part D plans will charge an annual deductible ($310 is standard) before covering any drug costs, up from the 45 percent that charged a deductible in 2009, according to the Kaiser Family Foundation.

• Fewer Part D plans will provide coverage in the so-called doughnut hole, which begins after you reach $2,830 in total drug spending and extends until your total drug costs for the year reach $6,440 in 2010; within that gap, you generally have to pay all the bills yourself. The plans that do provide some coverage in the doughnut hole usually cover only the cost of generic drugs; otherwise, you’re on your own.

• Be sure to check how each Part D plan treats your specific medications. Co-payments are rising, and many insurers are changing formularies. For example, you could end up with higher out-of-pocket costs if your insurer switches your drug from preferred to co-pay non-preferred.

• This year’s premium increases come on top of previous cumulative price hikes. Premiums for AARP MedicareRx Preferred, the most popular Part D plan, have risen by 50 percent since 2006, according to Avalere Health, a health-care consulting firm. Premiums for Humana Enhanced, also a popular plan, have increased by 180 percent over the same time period. In states where more providers are available, rates of increase have often been less.

 Ask your doctor whether you can switch any of your drugs to a generic or lower-cost medication; the policy with the best deal for brand-name drugs may not be the best deal for generics.

The Medicare prescription-drug-plan finder is an excellent tool to analyze the costs of Part D plans for your situation. Type in your drugs and dosages, and you’ll see total out-of-pocket costs — premiums as well as co-payments — for your medications throughout the year.

The Medicare health plan finder is an excellent tool to compare Medicare Advantage plans.

Or call (800) 633-4227 for personalized assistance from a Medicare representative..

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---HUGE MEDICARE ADVANTAGE (PART C) INCREASES FOR 2010

    INSURERS MAKE >> HUGE PREMIUM INCREASES >> HUGE BENEFIT DECREASES

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             By, Robert Fassbach, editor, www.SeniorArk.com

What you are about to read has NOTHING to do with any of the current health insurance reform legislation. Nothing has been passed, and if it had been, would not affect Medicare Advantage in 2010. What you will read has been the act of a private insurer, and makes the case for strong government intervention in our healthcare insurance delivery system.

October 6, 2009 - - My wife and I received a little gem in the morning mail today: the terms of our Medicare Advantage plan (also known as part C) for the coming year. COVENTRY ADVANTRA GOLD, a private insurer providing Medicare Advantage, HAS MADE HUGE INCREASES IN PREMIUMS AND CO-PAYS FOR 2010. And it has the potential to change our financial life as we have known it. We bet your insurer will do the same. There will be an expanded discussion of this in coming days, but here are some of the immediate highlights that pop out:

* The basic monthly premium has increased by 40.7%. Yes you have read it correctly, 40.7%.  But hold on - - there is much more - - and it gets much worse.

* In 2009 the first 8 days of hospitalization was fully covered. In 2010 we will each be liable for $170.00 for each of those days.

*The co-pay for seeing a specialist has increased by 40%, from $25 to $35 per visit.

* Occupational or physical therapy co-pays have increased by 75%, from $20 to $35 per visit.

* Diagnostic or therapeutic radiology services co-pays have increased 385%, from $25 to $90 for each event

Since my policy also includes my Part D drug plan, I must still investigate that aspect. But I am certain that my drug benefits under their policy will not have increased. Last year they simply decided that an important drug I needed would no longer be covered in any way. So I have done without. (A little tidbit on my prescriptions: In September I tried to refill Lipitor for 90 days. The druggist called for approval, and was told it was $45. But for the prior quarter I paid $10. I called Coventry today, and was told I should be paying $4.95 for 30 days, and about $10 for 90 days, but they needed to connect me with Medco, who manages their prescriptions. Medco told me that my price is somewhere over $200--and she emphasized that Lipitor is an expensive drug, and I should consider something cheaper. Understand, I paid $45 for a 3 month supply for the first quarter of the year and received a refund for overpayment. As I am typing this, I am on hold and they are investigating. Grrrrrrrrr!) Do we need efficient health insurance reform?

The total compensation for the CEO of Coventry in 2008 was $20,860,000.

(Source: Forbes.com)

THE BOTTOM LINE FOR YOU---NO MATTER WHICH MEDICARE ADVANTAGE PLAN YOU HAVE,  (20 percent of Seniors have Medicare handled by one of these), IS THIS: YOU MUST REVIEW ANY CHANGES THAT ARE BEING MADE BY YOUR PROVIDER. Then compare your plan with others. It may mean $$ thousands to you.

We just went to the Medicare comparison site, and it still only lists the plans for 2009. Stay posted on this SeniorArk, Home Page, News Section. We will update information on these private Medicare Advantage plans, and private Medi-gap (supplemental plans) when the Medicare site has them current. Watch this RED BOX for the latest.

You may change your Medicare advantage plan back to traditional Medicare only between November 25 and December 31, 2009. You may also select a different Medicare Advantage plan between November 15 and December 31, 2009. You may change to another Medicare Advantage insurance company, BUT NOT to traditional Medicare, between January 1 and March 31, 2010. (Is that as clear as mud?)

For many of us who chose the Medicare Advantage HMO-type approach in order to save money, it may be time to go back to traditional Medicare. What Coventry Advantra is offering for 2010 is little more than the "very basic" Medicare coverage.

Please give us feedback as you hear from your Medicare Advantage insurance companies. Your feedback will be published on the Senior Comments page, unless you request otherwise.

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