Significant 2011 Changes for Medicare Advantage
By Melissa A. Brown
If you have enrolled in the Medicare Advantage program, you should know that your plan is subject to change every year. In past years, premiums have risen, benefits have changed or been dropped altogether, and even provider networks have changed from time to time.
In 2011, Medicare Advantage beneficiaries may experience any or all of these changes, but there are some major program-wide changes to consider. Taking the time to learn and understand the changes will give you the information you need to make a sound decision about your 2011 Medicare Advantage policy. These changes do not apply to Medicare supplement policies.
Change to Enrollment Periods
Until now, there have been two primary enrollment periods:
- Annual Enrollment Period (AEP): Nov.15 – Dec. 31
- Open Enrollment Period (OEP): Jan. 1 – Mar. 31
Necessary changes to your Medicare coverage are made during the AEP. At that time, you can change or drop a plan or switch back to original Medicare. The AEP dates will not change for the year 2011.
However, the OEP will be unavailable for making like-to-like switches in plans starting in 2011. The only changes you will be able to make during the OEP is to drop your Medicare Advantage policy altogether, add Part D coverage or switch back to Medicare. This can only occur between Jan. 1 and Feb. 14. Your plan will be locked in as of Feb. 15.
MOOP Limits Will Change
The cap on maximum out-of-pocket costs — a feature that is not available through original Medicare — is a factor that has drawn many clients to purchase Medicare Advantage plans, and it is about to improve for most participants.
Only one-third of all Advantage plans in 2010 offered a MOOP, and even then they were often very high. In 2011, Advantage plans will all have a MOOP of no more than $6,700.
Private Fee-For-Service Plan Changes
Premium increases will be seen in many private fee-for-service plans (PFFS) or they will not renew at all in 2011. Due to new legislation, there will be fewer PFFS plans available in 2011. Plans that will remain in effect will see sharp rises in premium rates.
In service areas with multiple network-based plans, PFFS providers will have to put a network in place. This is because new legislation requires PFFS plan carriers to give members access to a provider network.
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or to Changes
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