Your Weekly Medicare
Consumer Advocacy Update
Don't Force People with Medicare to Pay More for Less
November 29, 2012
Volume 3, Issue 45
There is about one week left in Fall Open Enrollment, the time of year when you can change your Medicare coverage. You can join a new Medicare private health plan (Medicare Advantage (MA) plan) or stand-alone prescription drug plan (PDP). If you have an MA plan, you can also return to Original Medicare with or without a stand-alone PDP. All changes must be completed by December 7, unless you were affected by Hurricane Sandy.
Part D drug plans and Medicare Advantage plans vary greatly in terms of costs and coverage. Each January, plans change their coverage and costs for the new calendar year. Every fall, you should go over your plan’s coverage and compare it with other plans in your area to make sure you have the coverage that is best for you. Examine a plan’s coverage, costs, drug coverage and the pharmacies in its network to see if it best meets your needs. After considering those factors, you can use the plan’s star rating from Medicare to help you select a plan that’s right for you.
Medicare uses a Star Rating System to measure how well Medicare Advantage and prescription drug (Part D) plans perform. Medicare scores how well plans did in several categories, including quality of care and customer service. Ratings range from 1 to 5 stars, with five being the highest and one being the lowest score. Medicare assigns plans one overall star rating to summarize the plan’s performance as a whole. Plans also get separate star ratings in each individual category reviewed. The overall star rating score provides a way to compare performance among several plans. To learn more about differences among plans, look at plans’ ratings in each category.
Medicare reviews plan performances each year and releases new star ratings each fall. This means plan ratings change from one year to the next. Medicare sets the categories and reviews each plan the same way. You should look at coverage and plan costs, such as if the Part D plan covers all the drugs you take and has a premium you can afford before you consider the star rating.
This week marks the launch of the Coalition to Protect the Rights of New York’s Dually Eligible. This diverse coalition consists of health, aging and disability advocates, along with community- and faith-based organizations. The coalition will be critical to working with insurers, provider groups, and state and federal policymakers to protect the rights of vulnerable individuals as New York State transitions at least 124,000 men and women who are dually eligible for Medicare and Medicaid into new managed care insurance plans by 2014.
The new coalition’s steering committee, consisting of the Medicare Rights Center, Center for Disability Rights, Center for Independence of the Disabled NY, Community Service Society of NY, Empire Justice Center, Legal Aid Society, New York Association on Independent Living, and Selfhelp Community Services, has welcomed dozens of health care and disability stakeholders to date. The coalition has been made possible through a generous grant from the New York State Health Foundation.