"There are so many different choices available that many seniors don't know where to start when trying to select the coverage that is best for them," said Kerry DeFoe, GeorgiaCares coordinator for the Northwest Georgia Regional Commission Area Agency on Aging. "Choosing between a stand-alone prescription drug plan, a Medicare Advantage health plan that includes drug coverage or a [Part C] Medicare Advantage Plan that does not include drug coverage adds to the confusion.
"The Annual Enrollment Period is only six weeks long, running from [Nov. 15 to Dec. 31] in 2010. Medicare beneficiaries are bombarded with mailings before and during the enrollment period, which increases the amount of information to be reviewed and filtered."
To help become better informed, DeFoe encourages seniors to visit www.Medicare.gov, or call 1-800-633-4227 or GeorgiaCares at 1-800-669-8387. While these support systems cannot offer advice, they can provide details, such as an estimate of a plan's annual cost.
"The GeorgiaCares [State Health Insurance Assistance Program] network provides one-on-one assistance, so that callers can get personalized help as they compare their options and decide on which plans best meet their needs," said Dr. James J. Bulot, director of the DHS Division of Aging Services, in a news release from the Georgia Department of Human Services.
According to the Georgia DHS' website, www.dhr.georgia.gov, "GeorgiaCares SHIP services are free and also assist Medicare beneficiaries on Medicare, Medicaid and Medigap matters, including long-term care insurance, claims, resolution to billing problems, information and referral on public benefit programs aimed at those with limited incomes and assets, and other health care insurance information.
"GeorgiaCares SHIP urges everyone to review their coverage and make sure that any changes to the plan for 2011 will still meet their needs. Beneficiaries who do not want to make a change can remain in their plan from 2010."
There are several options open to seniors, who wish to partake in open enrollment for Medicare Part C and D.
"Available options are Medicare Part D prescription plans with Original Medicare and Medicare Advantage Plans, which are written by private insurance companies and take the place of Original Medicare," DeFoe said. "Part D plans all have a monthly premium and standardized co-pays for medication when filling a prescription. Most have a deductible, and the 2011 maximum allowed deductible is $310. Premiums range from approximately $18 to over $100 per month.
"All Part D plans for 2011 are subject to the coverage gap, which begins when the cost of a beneficiaries' medications reaches $2,840," she said. "After that time, beneficiaries will be responsible for 50 percent of the cost of brand name medications and 93 percent of the cost of generic medications, until their total out of pocket expense for the year reaches $4,550. After that time, beneficiaries will only be responsible for 5 percent of the cost of their medications for the remainder of the year.
"Medicare Advantage Plans are health plans written by private insurance companies and approved by and contracted with Medicare. Beneficiaries who enroll in these plans still have Medicare, and still must pay for Medicare but the Advantage Plan pays for their health care instead of Medicare. Advantage Plans come with and without Part D coverage and all are subject to the coverage gap. Some Advantage Plans offer vision and dental coverage options, which you can't get with Original Medicare. Most have a separate premium for health and prescription coverage, and there are even a few in some areas with zero monthly premium. Not all plans are available in all areas -- [leading to] more confusion."