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| Medicare Plans Terminate, Raise Premiums, Raise Copays! What Will You Pay in 2010? |
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| Written by Dana Cutter | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Each year, private Medicare insurance plans evaluate their ability to effectively provide Medicare insurance. As the Medicare rules change from time to time (read more), private Medicare insurance companies have to make decisions about whether to continue to offer the same insurance plans, raise premiums, or terminate plans. This year, many private Medicare insurance carriers have made the decision to terminate their Medicare Advantage Private Fee for Service, PPO and even in a few cases their HMO plans. You can expect that the plans that remain will raise premiums and increase the amount of services that require a copay. Bottom line, you'll have less choices and you will pay more – $5 and $60 more – than you paid in 2009.
* Plan premiums vary by county/zipcode (source Health Insurers Websites, Canton, MA 02021). All plans include medical and prescription drug coverage in the donut hole. Each company offers lower tier plans with and without prescription drug coverage. Only Fallon Community Health Plan is continuing to offer their $0 premium medical plan for 2010.
Overview of PFFS Plan Changes:
An estimated 660,000 Medicare consumers (source: WSJ) will need to enroll in a new plan during the 2010 open enrollment period (Nov 15 – Dec 31st). Medicare PFFS plans are Medicare health plans sponsored by private insurance companies, such as Blue Cross Blue Shield, Harvard Community Health Plan, Tufts Medicare Preferred and many others in Massachusetts. Medicare PFFS plans are popular among consumers because they are not required to have a doctor or hospital network. Medicare beneficiaries are allowed to visit any doctor or hospital as long as the doctor or hospital is willing to accept payment from the insurance company.
If you are enrolled in a Medicare PFFS plan that has been canceled for next year (2010), you will receive information in the mail from your Medicare insurance carrier with instructions regarding your options. Generally, an Original Medicare plan or a Medicare Advantage PPO plan may provide you with the closest experience to a Medicare Advantage PFFS plan. Please keep in mind, you are not required to remain with the same carrier if your PFFS plan was canceled. You may select a plan offered by the same insurance carrier or pick a new plan from a different insurance carrier in the area.
Are you “mad as hell” about these changes? Did your insurance plan terminate? Did your insurance plan increase premiums and copays? Tells us about your experience. Scroll down and leave a comment at the end of this article or go to our Medicare Answers forum and leave a message for your health plan. Just click on "Health Plan Name" in and "New Thread".
How do I know if my plan is being canceled?
Your insurance carrier will send you a letter in the mail informing you that your plan has been canceled. The letters should be mailed by October 31st, 2009.
When will my insurance end?
Your Medicare Advantage PFFS insurance will end on 12/31/2009.
What is my deadline to enroll in a new plan?
The deadline to enroll in a new plan is 1/31/2010. If you are on a Medicare plan that is terminated, you are able to enroll beginning two months before the plan ends and up to 1 month after the plan terminates. If you don’t enroll by 12/31/2009, you will be automatically enrolled in Original Medicare on 1/1/2010. You will still be eligible to switch to a Medicare Advantage HMO or PPO plan through 1/31/2010.
Will PFFS plans be available in 2010?
Yes, Harvard Pilgrim Health Care will continue to offer their PFFS Plan in 2010. However, starting January 1st, 2011, Medicare will require ALL PFFS plans to for a network of doctors and hospitals. It is not likely that PFFS plans will survive. After all if they form a network, how will they differentiate themselves from other Medicare Advantage HMO and PPO networks?
What is the best plan for you?
Based on your health status, the plan that meets your needs best may vary dramatically from person to person. We encourage you to use a Medicare plan comparison tool to enter your health information and compare the plans in your area in order to find the right plan that meets your needs.
Where can I compare Medicare Advantage plans?
You can compare Medicare Advantage plans using our Find a Plan compare tool or you can use the Medicare.gov site.
What plan provides the most similar benefits to a Private Fee for Service Plan?
Generally, Original Medicare, Medicare Supplement or a Medicare Advantage PPO plan will provide the most similar benefits to a Medicare Advantage PFFS plan. If you choose the Original Medicare or a Medicare Supplement plan, you will need to sign up separately for a Medicare Prescription Drug plan. If you decide to enroll in a Medicare Advantage PPO plan, please note that most Medicare PPO plans include prescription drug coverage and charge higher fees if you go out of network.
What else can I expect during Open Enrollment?
October 1st – Insurance companies begin their marketing campaigns. You should expect to receive tons of mail starting on October 1st and ending around March 31st, 2010.
October 9th – Medicare.gov site goes live with the 2010 Plan information. This is an expected date so it may vary by a few days. Medicare beneficiaries may not enroll in a 2010 plan until November 15th, unless they are eligible for a special enrollment period.
October 15th – 30th – CMS will mail the Medicare & You handbook.
November 15th – You may begin enrolling in plans (Note: if your plan terminated, you may enroll prior to 11/15. If you are eligible to enroll prior to 11/15, you will have received information in the mail outlining your open enrollment period.)
December 31st – Last day to enroll during the Annual Open Enrollment.
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Health Insurers Announce Terminations of Medicare Advantage PFFS, PPO and a few HMO plans
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