Medicare Open Enrollment: Better Choices, Sooner

By Don Berwick, Administrator, Centers for Medicare & Medicaid Services

Every year, people with Medicare get to explore new choices and pick the plans that work best for them. This year, this Open Enrollment period is starting early – on October 15 – and ending sooner – December 7.

As health plans start their marketing and advertising activities in just a few weeks, we want people to know that the Medicare program is strong and, in 2012, they have a broad array of choices. And, there are lots of new benefits thanks to the Affordable Care Act.

Every person with Medicare will have to choose a “Part D” plan to help them pay for prescription drugs. And people who have chosen to enroll in a “Part C” Medicare Advantage plan for their basic health care services have the option of staying in that plan, choosing a different plan, or going back to the Original Medicare program. These are important choices that should be made with care.

The good news is we have strengthened consumer protections and improved plan choices. We’re making it simpler for people to choose a new health or drug plan by reducing the number of duplicate plans. We’ve also worked with plans to reduce cost sharing on important benefits like inpatient hospitalization and mental health services.

And, thanks to our enhanced bargaining power we can report that average premiums for a Part D plan will be the same in 2012 as in 2011. The average premium for Part C plans is going down by 4 percent. That’s great news for people on Medicare who have a fixed income.

As with last year, people with Medicare will continue to have a variety of Medicare Advantage plan choices. Consumers in every part of the country will have a wide variety of Part D plan choices in 2012, including many plans with zero deductibles and plans with some form of generic gap coverage.

People with Medicare are also enjoying important new benefits. Every person is entitled to an Annual Wellness Visit with their doctor so that they can discuss their health and their health care needs. Prevention services like mammograms and other cancer screenings are now available with no cost-sharing. And people who reach the donut hole in their drug costs will get a 50% discount on covered brand name drugs and a 14 percent discount on generics. That puts money back in your pockets.

More good news for consumers is the fact that we’ll be closely monitoring marketplace performance to protect people from misleading information or prohibited tactics by a small minority of unscrupulous plans. Medicare plans are on notice: we’ll move quickly to take action against plans found to be violating marketing rules.

In short, there’ll be a wide range of health and drug plan options available across the country, including Original Medicare. People can turn to www.medicare.gov, call the 1-800-MEDICARE hotline, or consult with a local State Health Insurance Assistance Program (SHIP) for help. We want to make sure people can identify and enroll in the coverage option that suits their needs in 2012.

Strengthening Medicare: Halting Cuts to Medicare Payments

By Kathleen Sebelius, Secretary of Health and Human Services

It’s important to protect the high-quality health care currently available to people with Medicare. Unfortunately, the 23% cut in Medicare payments to doctors that is scheduled to go into effect at the end of November has the potential to disrupt the health care that millions of Medicare beneficiaries rely on.

Today, in a speech to the Association of American Medical Colleges, I spoke about why this Administration has made it a priority to ensure this extreme cut in payments to doctors is addressed during the upcoming Congressional session. Here’s an excerpt from my speech:

“…[We] know that health care providers also face significant barriers as you strive to deliver the best care possible. And we’re committed to working with you to reduce them.

That starts with preventing the 23% cut in Medicare payments to doctors that’s scheduled to take effect at the end of the month. These drastic cuts could force doctors out of the Medicare program and jeopardize the care of our seniors.

On Thursday, I attended a Cabinet meeting where the President stressed that preventing these potentially disastrous cuts must be one of our top priorities. The American Medical Association has proposed a 13 month extension. And I hope that Congress will act quickly to pass it, so that our doctors and seniors can have some peace of mind while we work on a long-term fix.

There’s been a lot of talk in the last few months about Medicare and its future. The single biggest step we can take to strengthen Medicare for seniors and disabled Americans is to make sure these disruptive cuts don’t take effect.

As the President has said many times, we will ultimately need a permanent fix, so that the livelihoods of the hard-working doctors who care for seniors and people with disabilities are no longer subject to politics. But in the meantime, we don’t want any doctor to be stuck in a limbo where they don’t know week to week how much they’ll be paid for the services they deliver.

That’s why we’re urging Congress to act now to make sure that you can continue to provide the high quality care our seniors depend on every day.”

Strengthening Medicare is a core value for this Administration. We will continue to act to ensure that the program and the people who receive care and provide care have the resources they need. To learn more about other ways we are working to strengthen Medicare, especially through the Affordable Care Act, click here.