Medicare open enrollment is around the corner for Florida seniors and families around the country.  It is an important time to review your Medicare coverage and costs to decide if it is wise to make a change for 2013.

At Aging Wisely, we always keep you up-to-date on the latest news and information on Florida Medicare and eldercare.  We will be publishing our updated Medicare Fact Sheet for 2013 as soon as those costs are available.  In the meantime, Medicare has published the annual Medicare and You handbook and we wanted to share some of the most recent information with you.

We have done a number of presentations in our local community about Medicare and healthcare reform (The Affordable Care Act or “Obamacare”).  One of the major changes being touted is the addition of much more extensive preventative care benefits.  According to the Center for Medicare and Medicaid services, more than 32.5 million people have received one or more preventive service at no cost.

In addition, the Affordable Care Act made changes to the “donut hole” in Medicare’s prescription drug benefit (a confusing reimbursement system which left a gap in “the middle” of coverage for some recipients).  The donut hole will be gradually closing as part of the reform laws.  In 2011, recipients who hit the donut hole received a 50% discount on brand name drugs to help cover the costs.  About 3.6 million people received the discounts in 2011, a savings of about $600 per person.  The Medicare D donut hole will be phased out by 2020.

What will be new for 2013?

More preventative services will be covered, such as depression screenings, screenings and
counseling for alcohol misuse and obesity, and behavioral therapy for cardiovascular disease.

The donut hole will continue to shrink.  If recipients reach the coverage gap, they’ll pay only 47.5% for covered brand-name drugs and 79% for generics.

Co-pays and deductibles will be at least slightly different, typically with small increases each year.  We’ll publish those for you as soon as they are released!  Be aware that certain premiums are now income-adjusted so higher earners pay more.  Part B and Part D premiums are higher for anyone making over $85,000/year (or $170,000 as a couple).

On the provider side, incentive payments (and penalties) are being integrated in to the reimbursement system.  For example, Medicare Advantage Plans that receive high quality scores will receive bonuses (in addition to the fact that 5-star plans can enroll recipients at any time).  Also, hospitals are facing penalties for high readmissions rates as well as incentives for quality of care measures.

Many analysts are expecting significant changes to the Medicare advantage landscape due to the payment and program changes.  While 2013 may or may not bring significant changes, every year there are a number of plans that change or stop services, both in Medicare Advantage and Part D.

Need Florida Medicare advice?  Help evaluating your annual open enrollment choices or signing up for Medicare for the first time?  Our Medicare Analysis services are for you!  Contact us at 727-447-5845 to schedule an appointment or find out more.