Medicare Part D Insurance – Enrollment Changes 2012

Medicare Part D Insurance - Enrollment Changes 2012Need to know enrollment changes for 2012 Medicare Part D insurance

Health care reform has meant some significant changes to enrollment periods for Medicare Part D insurance. The key to enrolling in the best Part D plan for 2012 is  knowing when you can and cannot enroll or make changes to your Part D insurance coverage.

Special Election Periods (SEP) aside, there have traditionally been two main enrollment periods for Part D. The Annual Enrollment Period (AEP) and the Open Enrollment period (OEP). The AEP will continue to be the time for Medicare beneficiaries to enroll in, or make changes to their Part D Medicare plan. The OEP is no longer be available. This was the enrollment period that began on January 1 and ended March 31. During this period when you were able to make like-to-like plan switches.

 

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Make your 2012 Medicare Part D enrollment count

There is a new Annual Enrollment Period time frame for plans with a 2012 effective date. You may submit an application beginning October 15, 2011 through December 7, 2011.  After this period there will be a dis-enrollment period for Medicare Advantage plan members. Advantage plan members who would like to dis-enroll from their plan can do so beginning January 1 through February 14. If they choose to dis-enroll they will have an opportunity to return to original Medicare and purchase a stand-alone Part D insurance plan. After that period members will be locked into their choice until December 31.

You will need to make your choice count since your freedom to make plan changes has be lessened. Shop online to compare Medicare Part D insurance plans for 2012 to save time. Plan aspects that you should consider include:

  • The plan’s formulary. Make sure your prescription drugs are included.
  • Compare co-pays from one plan to the next.
  • Compare individual drugs to determine if one plan includes them in a lower or higher tier than another plan.
  • Make sure your pharmacy will accept the plan and also compare mail order benefits.
  • Check to see if a plan will give you some coverage in the Donut Hole if there is a chance you may reach it.
  • Compare Part D insurance plans to determine if an annual deductible is required.
  • Consider the plan’s premium in relation to all other concerns.

What does Medicare Part D Cost?

All of these factors will take on a little more importance for 2012 due to the Medicare Part D insurance enrollment changes. Do your homework and make your choice based on sound analysis.


16 comments

  1. You say you wil compare plans,but all you do is push advertised plans.

  2. I’m sorry for the confusion. The article points our Medicare Part D enrollment changes for 2011. In addition, there is a list of things to consider when choosing a 2011 Part D plan. This site is not intended to compare the hundreds of Part D plans available across the US. Check out http://www.medicare.gov for find 2011 Part D plans in your area.
    Thanks David.

  3. I have AF. I had a stroke on 12/10/10 and spent 4 days in the hospital. I was prescribed a new anticoagulation drug PRADAXA which has many advantages over warfarin.
    1. PRADAXA is NOT on any formulary.
    2. It costs $278 per month but this amount does NOT COUNT IN CALCULATING MY DOUGHNUT HOLE STATUS!!!!!!!!!
    3. HOW CAN i OPT OUT OF ANY AND ALL THESE WORTHLESS PART D INSURANCE PLANS?????

  4. Ron, I’m sorry to hear about your difficulties. First, I would be irresponsible if I didn’t say that you shouldn’t opt of of Medicare Part D because a drug is not covered any more than you should opt out of Medicare in general because routine dental is not covered. I know there’s a big difference between an effective drug and routine dental, but you get my point. You are not required to have Part D insurance. You can notify your current carrier during this Annual Enrollment Period (Nov 15 – Dec 31) that you are not renewing coverage. But consider the consequence. NO COVERAGE FOR ANY MEDICATIONS IN 2011. They call it insurance for a reason. Don’t cut your nose off to spite your face. Better yet if you are married or have close family, ask them if they think you should just wing it and pay for all your drugs in 2011. I know what my wife would say! Here’s an article: http://affordablemedicareplan.com/medicare-formulary-changes-for-2011/, that may shed some light on why Pradaxa is not covered on any formulary (I’m taking your word for it, as I have not researched all formularies).

  5. ALSO:
    FOR 2010 I HAD GONE THRU THE DOUGHNUT HOLE AND EXPECTED TO PAY ABOUT $20 FOR PRESCRIPTIONS FOR THE REST OF THIS YEAR, BUT THE INSURANCE COMPANY CAN GREATLY INCREASE THEIR PROFITS BY JUST REFUSING TO PUT NEW DRUGS ON THEIR FORMULARY!!!!!!!!!!!!!!
    MEDICARE PART D HAS RIDICULOUS RULRS!!!!!!!!!!

  6. “Whoops! That Page Isn’t Here” IS THE RESPONSE I GET WHEN I CLICK ON YOUR LINK ABOVE.

  7. Ron, I think your anger is misplaced. Pradaxa was approved by the FDA on October 19 2010. Given the process to change formularies mid-year it’s understandable that it’s not on any 2010 formularies. Have your physician petition your Part D carrier to approve coverage for you. If not successful consider that the prevention of stroke in people with atrial fibrillation was treated successfully using other medication which are included in Part D formularies.

    Your logic that the insurance company is increasing their profit by not including Pradaxa on thier 2010 plan formulary is not sound. If you are paying for the drug, the drug manufacturer is making a profit not he insurance company. If it were the case you could also argue that by not covering (place the name of any other product you could purchase here) they are increasing their profits.

  8. Sorry about that Ron, I fixed the link. I think after I did a little research that the issue, it is how recently that the FDA approved the drug and not that it won’t be included on Part D formularies in the future.

  9. I have a question. I tried to disenroll from WelCare on Jan 3/2011 but was told I could not. However I can’t afford the jacked up premium. What are the consequences? Your answer would be greatly appreciated.
    Thanks in advance………..
    John

  10. John, This is the first year we have not had an Open Enrollment Period (Jan 1 – Mar 31) where we could switch plans. The only option now is for people who are enrolled in a Medicare Advantage Plan and would like to dis-enroll (Jan 1 – Feb 14), return to original Medicare and purchase a stand-alone Part D plan.

    You will need to have a Special Enrollment Period to change your Part D now. I’m not sure what happens if you stop paying your monthly premium. At worst, you would probably be without coverage until January 2012 and may have to pay some type of penalty. Although the idea of going without Part D coverage doesn’t sound all that good. If your having a hard time with the premium because your income is low you may qualify for low income assistance. Call Social security to find out. If you do qualify you can switch anytime you like. If it’s difficult because you have more month left over at the end of your money you may need to make some sacrifices. Sorry I’m not a greater help. U.S. Senator Bob Casey (D-PA) a few weeks ago introduced the Medicare Beneficiary Preservation of Choice Act which may bring back the Open Enrollment Period for next year. We’ll have to wait and see.

  11. Medicare formularies that do NOT include Pradaxa at $250 or so per month are wasting a huge amount of taxpayer money. My husband went into anaphylactic shock and nearly died from coumadin (warfarin)and is now on $5,600/month of Lovenox. Even the generic (enoxoprin) is $4,400 PER MONTH. His medicare advantage plan (Humana)happily pays the $67,200 per year rather than add the $3,000 per year for the Pradaxa to their Medicare formulary.

  12. Susan, Thanks for your insights. Pradaxa was approved by the FDA in late October 2010. I would expect that it will show up on formularies soon. I’m not sure Humana is happily paying the $67,200 per year as they have shareholders to keep happy. The hold up is probably with Medicare and not the insurance companies that would save a substantial amount of money.

  13. Ron, I enrolled in a medicare advantage plan 1-1-2011 and it was my first time on a medicare advantage plan I was on traditional medicare and a medicare suppliment plan and I was told by some friends that if it was my first time on that type of plan I could disenroll out of the my plan and go back to my medicare suppliment plan as long as I did it in the first year of enrollment but am having trouble with the company trying to get a letter of disenrollment I should be able to disenroll shouldnt I?

  14. Dean, There are two separate issues at play here. There is an Annual Dis-enrollment Period that began January 1 and ended February 14 where you could have done what you are desiring. But that’s past. The other concept is to choose not to renew your plan for another year during the Annual Enrollment Period and then return to a Medicare supplement with guaranteed issue rights. The Annual Enrollment Period for 2011 is October 15 to December 7.

  15. after filling out the app. for free month of pradaxa it is said to press submit, there is no submit on or near app ,and when you click on continue which is on the bottom left corner of app. the app gos away.

  16. Michael, I’m sorry your having difficulty but your issue seems to be with another website. This site doesn’t offer a free month of Pradaxa.

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