The Medicare Part D annual election process is quickly approaching it runs from November 15 – December 31. CMS projects that for 2011, 1.2 million beneficiaries will have to change plans as a result of their current plans leaving the market or reducing their service area. According to the Center for Medicare Advocacy, this a result of additional requirements passed in the 2008 Medicare Improvement for Patients and Providers Act (MIPPA), not the recent health care reform law.
Beneficiaries whose plans leave Medicare will still have health insurance through the traditional Medicare program. Their will be a special enrollment period in which to enroll in a Part D plan or another Medicare Advantage plan, and you will have guaranteed issue rights to certain Medigap policies. If your plan is leaving Medicare, beneficiaries should also be on the lookout for their plan’s non-renewal notice. If your plan will be available in 2011, you should also read the Annual Notice of Change (ANOC) to learn if or how the plan is changing for next year.
Here are some other changes to Medicare Part D:
- The “Donut Hole” is being phased out as a result of the Affordable Care Act. In addition, plan sponsors were required to consolidate their plan offerings so that there are fewer plans, and differences between plans are more meaningful and easy to compare. Also, the Donut Hole will be phased out over the next 10 years, with additional drug discounts available.
- For the Standard Benefit, the Out-of-Pocket Threshold, $4,550, will not change in 2011, but it will be gradually reduced from now until 2020, when the Donut Hole is completely eliminated.
- People who are enrolled in the Part D Low Income Subsidy (LIS) program may be auto-enrolled into “benchmark” plans so their premiums will be covered in full or on a sliding scale. Benchmark plans offer basic coverage and have low premiums. Every year many LIS-eligible individuals are reassigned to a new benchmark plan because the plan they are in no longer qualifies as a benchmark plan. However, the new health care reform law changed how benchmark plans are calculated. As a result only about 500,000 beneficiaries will have to be reassigned for 2011 plan year, the lowest number of reassignments since Medicare – Part D began. CMS estimates that 1.5 million more beneficiaries would have been reassigned if the law had not been changed. The Affordable Care Act also requires that beneficiaries who are reassigned get more detailed information their drug coverage.