There are some significant changes coming to Medicare in 2011, as a result of healthcare reform and a number of initiatives. Here is a brief summary of the key changes:

Preventative Services:

Next year, all Medicare preventive services, such as screenings for colon, prostate and breast cancer, will be free. Annual wellness visits will also be free starting in 2011. *In the past, Medicare allowed for a one time “welcome to Medicare” wellness/physical only.

Durable Medical Equipment:

In certain areas, recipients will be required to go through specific providers.

“Doughnut hole” changes/Medicare Prescription Drug Benefit:

2010: Anyone who fell in to the “doughnut hole” received a $250 rebate check to assist with those costs. This doesn’t apply to those receiving “special assistance” with costs through Social Security. Be aware that there have been several scams related to this rebate, as well as continued scams where clients are asked for their Medicare # or contacted via phone to sign up for a new plan.

2011: 50% discount on covered brand name drugs in doughnut hole period

2012-2020 and beyond: This discount incrementally increases until eventually the coverage gap is eliminated.

New open enrollment periods/dates to change plans:

1/1/11-2/14/11: If you’re in a Medicare Advantage Plan, you can leave your plan and switch back to original Medicare (and join a prescription drug plan)-coverage effective 1st day of month after the plan gets your enrollment.

10/15/11-12/7/11: New Open Enrollment period for switching Medicare health & prescription drug plans (effective 1/1/12). This is the period that has previously been 11/15-12/31 each year (including 2010)—the purpose is to allow more time for decisions, as well as processing before the effective date.

Healthcare Information Technology:

There is a big push towards use of information technology to streamline and improve healthcare, such as electronic prescribing and personal health records. Medicare has information and resources on their site, though there remains no universal system at this time.

Income Adjusted Premiums:

Currently, Part B premiums are income adjusted for higher income individuals. Sarting in 2011, higher income individuals (those making more than $85,000 filing an individual return and $170,000 filing jointly) will also pay an income-related monthly adjustment to Part D premiums. This will be deducted from the recipient’s Social Security check, no matter how they usually pay the Part D premium.

Medicare Advantage Plans:

Subsidies to these plans will be phased out. This may mean plans reduce extra benefits, or even decide to no longer participate in this market, but those will be business decisions by the insurance companies so the impact is unclear at this point.

The Medicare and You 2011 Guidebook is currently available on Personal Medicare Analysis provides you the best, unbiased information so that you can make wise decisions and save money on healthcare in retirement.