Health insurance rate hikes in Arizona deemed excessive by US Health and Human Services

Secretary Sebelius calls on insurance company to drop unjustified rate hikes

U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius announced today that health insurance premium increases in Arizona have been deemed unjustified under the rate review authority granted by the Affordable Care Act.

"Thanks to the Affordable Care Act, consumers in every state are getting a straight answer from insurance companies who raise their rates by 10 percent or higher," said Secretary Sebelius.  "It’s time for this company to immediately rescind these unjustified rate hikes, issue refunds to consumers, or publicly explain their refusal to do so."

Since the rate review program began in September 2011, health insurers have proposed fewer double-digit rate increases. Furthermore, more states have taken an active role in reducing rate increases, and consumers in all states are getting straight answers from their insurance companies when their rates are raised by 10 percent or more.

In the decisions announced today, HHS determined, after independent expert review, that one insurance company has failed to justify a proposed rate increase in Arizona’s individual association plan market. The excessive rate hikes would affect 340 Arizonans.

The insurer has requested rate increases of 16.7 and 20.1 percent. These increases were reviewed by independent experts to determine whether they are reasonable.  In this case, HHS determined that two rate increases were unjustified, because the insurer failed to provide adequate data for a review.

Most rates are reviewed by states and many states have the authority to reject unreasonable premium increases.  Since the passage of the health care law, the number of states with this authority increased from 30 to 37, with several states extending existing “prior authority” to new markets.

This initiative is one of many in the health care law to ensure that insurance companies play by the rules, prohibiting them from dropping coverage when a person gets sick, billing consumers into bankruptcy through annual or lifetime limits, and, soon, discriminating against anyone with a pre-existing condition.

 

Information on the specific determinations made today is available at: http://companyprofiles.healthcare.gov/

 

A comprehensive report on the rate review program is available at: http://www.healthcare.gov/law/resources/reports/rate-review03222012a.html

 

General information about rate review is available at: http://www.healthcare.gov/law/features/costs/rate-review/

Low income patients to receive free colonoscopies for colorectal cancer screening

Starting Wednesday, March 28, Arizona Digestive Health physicians and staff, with three collaborative sponsors, will perform as many as 50 colonoscopies in three days

 

FOR IMMEDIATE RELEASE:   March 21, 2012

PHOENIX – As part of its education and prevention efforts for Colon Cancer Awareness Month this March, Arizona Digestive Health is joining with the Center for Disease Control (CDC),  the Arizona Department of Health Services (ADHS),  Arizona Chapter of Colon Cancer Alliance (CCA) , and Mountain Park Health Center to provide free colon cancer screenings to low-income, underinsured or uninsured members of the community.

 

Starting Wednesday March 28, Arizona Digestive Health physicians and staff, in collaboration with the other three collaborative partners, will perform as many as 50 colonoscopies in three days through the CDC’s Colorectal Cancer Control Program (CRCCP).

 

Mountain Park Health Center will identify participating patients who have no coverage for colorectal cancer screening or are unable to pay. Interested individuals who wish to participate in this pilot program can call Raquel Acosta, Cancer Program Manager at (602) 323-3380.

 

The Arizona Chapter of the Colon Cancer Alliance will provide funding for colonoscopy preparation materials for the participating patients as well as provide funds to cover fuel expenses for those traveling to the event. The CCA is a national patient advocacy organization dedicated to ending the suffering caused by colorectal cancer. In order to increase rates of screening and survivorship, CCA provides patient support, education, research and advocacy across North America.

 

Using funds received from the Colon Cancer Alliance’s Undy5000, ADHS, through contracted partners, will purchase Pre-Existing Condition Insurance Program coverage for any patients that may be diagnosed with colorectal cancer during this event.  For the uninsured unable to access this event, ADHS has the Fit at Fifty Health Check Program providing colorectal cancer screening for uninsured Arizonans.  This program is Arizona’s component of the Colorectal Cancer Control Program and is funded by the CDC. Interested individuals can call (602) 323-3377 for more information.

 

Colon cancer is the second leading cause of cancer deaths in the United States, but is preventable when caught early. According to recent studies, colonoscopy alone can reduce a patient’s risk of dying from colon cancer by more than 50 percent. “One of our main priorities as gastroenterologists is the prevention of colon cancer, and this program is a valuable part of that effort, said Dr. Paul Berggreen, president of Arizona Digestive Health.“We are happy to donate our services and resources to ensure this effort is a success now and in future years.”

 

Beginning in 2009, the Colorectal Cancer Control Program works to increase colon cancer screening rates among men and women age 50 to 64. Through non-profit organizations, corporate sponsorship and volunteers, many of the CRCCP’s initiatives are at no cost to the patient. More information about CRCCP is available online at, www.cdc.gov/cancer/crccp/.

 

About Colonoscopy: Colonoscopy is advised for all patients, age 50 and older, as a method of colon cancer screening. The procedure is performed using a colonoscope, a long flexible tube that permits visualization of the lining of the large bowel with a video monitor. The instrument is inserted via the rectum and guided through the length of the colon. Colonoscopy is a valuable tool for the diagnosis and treatment of many diseases of the large intestine; especially colon polyps and cancer.

 

About Arizona Digestive Health: Founded in 2007, Arizona Digestive Health consists of 58 board certified physicians practicing at 26 locations throughout Maricopa County. Our staff is committed to providing an outstanding level of care through thoughtful and comprehensive consultations and the most advanced diagnostic and therapeutic procedures available. To learn more, visit us at www.arizonadigestivehealth.com, on Facebook or Twitter.

 

# # #

 

The Arizona Chapter of the CCA is proud to participate in this pilot year colorectal cancer screening project with the above partners as part of the Colon Cancer Awareness Month this March. The CCA has over 37,000 members. The CCA help line receives an average of 700 calls monthly, and their support networks have assisted over 150,000 people. The growth and success of the organization is due in large part to caring volunteers who devote considerable time, skill and energy to achieving CCA's vision. Join the CCA in their determination to prevent and increase awareness of colorectal cancer. To learn more about CCA, visit the CCA website: www.ccalliance.org.

                                                                            

Health reform law provides coverage for some 50,000 Americans with pre-existing conditions

Pre-Existing Condition Insurance Plan saves lives

 

Health and Human Services Secretary Kathleen Sebelius today announced that the new health care law’s Pre-Existing Condition Insurance Plan (PCIP) program is providing insurance to nearly 50,000 people with high-risk pre-existing conditions nationwide. The Department released a new report demonstrating how PCIP is helping to fill a void in the insurance market for consumers with pre-existing conditions who are denied insurance coverage and are ineligible for Medicare or Medicaid coverage.

 

“For too long, Americans with pre-existing conditions were locked out of the health care system and their health suffered,” said HHS Secretary Kathleen Sebelius. “Thanks to health reform, our most vulnerable Americans across the country have the care they need.”

 

Under the Affordable Care Act, in 2014, insurers will be prohibited from denying coverage to any American with a pre-existing condition. Until then, the PCIP program will continue to provide enrollees with affordable insurance coverage.

PCIP is helping individuals like:

 

·         Randy Morales, of Mi-Wuk Villlage, California (Tuolumne County), a small business owner. Randy and his wife Judy had dropped their individual health insurance policies a few years ago because of the cost. In the fall of 2010, Randy was diagnosed with invasive squamous cell cancer in his throat. Uninsured and uncertain of how to pay for treatment, Randy called HIAS looking for coverage options. The call specialists told him about the PCIP program in California, and he was able to enroll in time for coverage to take effect so he could have necessary surgery. After 35 radiation treatments and seven rounds of chemotherapy, in October 2011 Randy was told he is in remission. He estimates that his treatment cost more than $135,000, and there’s no way he could have paid for that out of pocket. He continues to receive follow-up care every six months and finds the program to be very user-friendly.

“When I was diagnosed, I was told it was stage 4d. Stage 4e is dead. And to come back from that diagnosis where I was told to get my life in order to where I’m sitting here in remission is a total 180 degree change in my mindset. PCIP was a life saver,” Randy said.

 

·         Gail O’Brien of Keene, New Hampshire who is now getting help with non-Hodgkin’s lymphoma treatments and is responding very well.

 

·         James Howard of Katy, Texas who is grateful for the coverage the PCIP program is providing to treat cancer and says that without it, he would not have been able to continue receiving care.

 

 

 

In many cases, PCIP participants have been diagnosed with and need treatment for serious health care conditions such as cancer, ischemic heart disease, degenerative bone diseases and hemophilia.  As a result of the new law, PCIP enrollees are receiving health services for their conditions on the first day their insurance coverage begins.  Their critical need for treatment, combined with their lack of prior health coverage has led to higher overall per-member claims costs in state-based PCIPs of approximately $29,000 per year, which is more than double the per member cost that traditional State High Risk Pools have experienced in recent years.

 

Enrollment in PCIP has seen a nearly 400 percent increase from November 2010 to November 2011.  PCIP enrollment is anticipated to trend upwards of 50,000 enrollees within the coming month.

 

People who enroll in the PCIP program are not charged a higher premium because of their medical condition.  Program participants pay comparable premium rates to healthy people in the individual insurance market.  By law, premiums may vary only on the basis of age, geographic area and tobacco use.  

 

PCIP provides comprehensive health coverage, including primary and specialty care, hospital care, prescription drugs, home health and hospice care, skilled nursing care, preventive health and maternity care. The program is available in 50 states and the District of Columbia and open to U.S. citizens and people who reside in the U.S. legally (regardless of income) who have been without insurance coverage for at least six months, and have a pre-existing condition, or have been denied health insurance coverage because of a health condition. 

 

The Affordable Care Act directed the Secretary of HHS to carry out PCIP either directly or through a contract with a state or nonprofit entity.  In 27 states, a state or nonprofit entity elected to administer PCIP, while HHS operates the program in the remaining 23 states and the District of Columbia. 

 

The new report can be found at:  http://www.cciio.cms.gov/resources/files/Files2/02242012/pcip-annual-report.pdf

 

For more information, including eligibility, plan benefits and rates, as well as information on how to apply, visit www.pcip.gov and click on “Find Your State.” Then select your state from a map of the United States or from the drop-down menu.

The PCIP call center is open from 8 a.m. to 11 p.m. Eastern Time. Call toll-free 1-866-717-5826 (TTY 1-866-561-1604).

PCIP Enrollment Fact Sheet: http://www.healthcare.gov/news/factsheets/2012/02/pcip02232012a.html

Health reform law saves $2.1 billion for 3.6 million Medicare recipients

New data show average American with Medicare to save nearly $4,200 through 2021 thanks to health reform

3.6 million people with Medicare saved $2.1 billion on their prescription drugs in 2011 thanks to the Affordable Care Act, according to data issued today by the Department of Health and Human Services (HHS). Savings for people with Medicare will increase over time. According to today’s new report from HHS, the average person with Medicare will save nearly $4,200 by 2021 because of the new law.

“The Affordable Care Act is already saving money for millions of Americans with Medicare,” said HHS Secretary Kathleen Sebelius.  “As we move forward, we will close the donut hole completely and save even more money for everyone with Medicare.”

The Affordable Care Act provides a 50 percent discount on brand-name prescription drugs and this year, a 14 percent discount on generics. Last year, it provided a seven percent discount on covered generic medications for people who hit the prescription drug coverage gap known as the donut hole last year, with 2,814,646 beneficiaries receiving $32.1 million in savings on generics.

In 2011, the 3.6 million Americans who hit the donut hole saved an average of $604 on the cost of their prescription drugs.

Data also show that women especially benefitted from the law, with 2.05 million women saving $1.2 billion on their prescription drugs.

By 2020, the donut hole will be closed completely.  The new report released today by the Department of Health and Human Services finds that this provision and other features of the health reform law will generate substantial savings for people with Medicare. Typical Medicare beneficiaries will save an average of nearly $4,200 from 2011 to 2021. People with high prescription drug costs could save as much as $16,000.

The savings are a product of provisions in the Affordable Care Act and other cost trends that:

·         Decrease prescription drug costs for seniors

·         Make preventive services like mammograms free for everyone in Medicare

·         Reduce growth in Part B premiums (for physician services)

·         Reduce growth in cost-sharing under both Parts A (hospital care) and Part B.

These announcements come one day after HHS announced that in 2012, Medicare Advantage premiums have fallen by seven percent on average and enrollment has risen by about 10 percent since last year.  For more details on that announcement, visit http://www.hhs.gov/news/press/2012pres/02/20120201a.html

For state-by-state savings figures for today’s donut hole announcement, visit: http://www.cms.gov/Plan-Payment/

For more information about donut hole savings, visit http://www.cms.gov/apps/media/fact_sheets.asp

For the report regarding savings those with Medicare will see over time, visit http://www.aspe.hhs.gov/_/index.cfm

Affordable Care Act holding insurers accountable for premium hikes

 Insurance premium increases in Arizona and four other states deemed "unreasonable."

 

Health insurance premium increases in Arizona and four other states have been deemed “unreasonable” by the U.S. Department of Health and Human Services, HHS Secretary Kathleen Sebelius announced today. 

 

After independent expert review, HHS determined that Trustmark Life Insurance Company has proposed unreasonable health insurance premium increases in five states—Alabama, Arizona, Pennsylvania, Virginia, and Wyoming.  The excessive rate hikes would affect nearly 10,000 residents across these five states.

 

To make these determinations, HHS used its “rate review” authority from the Affordable Care Act (the health care law of 2010) to determine whether premium increases of over 10 percent are reasonable. 

 

"Before the Affordable Care Act, consumers were in the dark about their health insurance premiums because there was no nationwide transparency or accountability," said Secretary Kathleen Sebelius.  "Now, insurance companies are required to disclose rate increases over 10 percent and justify these increases.  It’s time for Trustmark to immediately rescind the rates, issue refunds to consumers or publicly explain their refusal to do so."

 

In these five states, Trustmark has raised rates by 13 percent.  For small businesses in Alabama and Arizona, when combined with other rate hikes made over the last 12 months, rates have increased by 27.2 percent and 18.1 percent, respectively.  These increases were reviewed by independent experts to determine whether they are reasonable.  In this case, HHS determined that the rate increases were unreasonable because the insurer would be spending a low percent of premium dollars on actual medical care and quality improvements, and because the justifications were based on unreasonable assumptions.

 

In addition to the review of rate increases, many states have the authority to reject unreasonable premium increases.  Since the passage of the health care reform law, the number of states with this authority increased from 30 to 37, with several states extending existing “prior authority” to new markets. 

 

Examples of how states have used this authority include:

 

·         In New Mexico, the state insurance division denied a request from Presbyterian Healthcare for a 9.7 percent rate hike, lowering it to 4.7 percent;

·         In Connecticut, the state stopped Anthem Blue Cross Blue Shield, the state’s largest insurer, from hiking rates by a proposed 12.9 percent, instead limiting it to a 3.9 percent increase;

·         In Oregon, the state denied a proposed 22.1 percent rate hike by Regence, limiting it to 12.8 percent.

·         In New York, the state denied rate increases from Emblem, Oxford, and Aetna that averaged 12.7 percent, instead holding them to an 8.2 percent increase.

·         In Rhode Island, the state denied rate hikes from United Healthcare of New England ranging from 18 to 20.1 percent, instead seeing them cut to 9.6 to 10.6 percent.

·         In Pennsylvania, the state held Highmark to rate hikes ranging from 4.9 to 8.3 percent, down from 9.9 percent.

 

Today’s announcement comes the same week that a report showed that health care spending has grown at remarkably low rates.  According to an analysis done each year by the Centers for Medicare & Medicaid Services, U.S. health care spending experienced historically low rates of growth in 2009 and 2010.  A recent study released by Mercer Consulting also showed a slow-down in the average employee health benefit cost to businesses.

 

The Affordable Care Act includes several policies, including rate review, to continue this slow growth.  By fighting fraud, better coordinating care, preventing disease and illness before they happen and creating a new state-based insurance marketplace, it helps keep health care cost growth low.

 

For more information on the specific determinations made today, please visit http://companyprofiles.healthcare.gov/

 

For general information about rate review, visit: http://www.healthcare.gov/law/features/costs/rate-review/

Governor: Health care plan for state will allow 20,000 children to join KidsCare

Governor Brewer, area hospitals unite for Health Care Initiative

 

Plan leverages federal dollars to fund uncompensated care, hospital improvements

 

PHOENIX – Governor Jan Brewer and executives from three of the state’s largest health institutions came together today to announce a plan that will offset hospital costs in providing care to the uninsured, fund service improvements and allow nearly 20,000 Arizona children to join KidsCare.

 

And all at no state cost.

 

“Creative, collaborative solutions are a must in these times of tight budgets and growing costs,” said Governor Brewer. “I’m proud that Phoenix Children’s Hospital, Maricopa Integrated Health System and the University of Arizona Health Network have joined us to make this plan a reality. The fact that we can accomplish this with no cost to the state is just icing on the cake.”

 

Last spring, Governor Brewer signed into law SB 1357, which enabled AHCCCS to use local government funds in order to provide care to individuals no longer covered by Medicaid. Under the plan announced today, Phoenix Children’s Hospital, Maricopa Integrated Health System and the University of Arizona Health Network will put forward $113 million. This funding, routed through MIHS and Pima County, will serve as the state match in order to draw down more than $229 million from the federal government.

 

This funding will be used to:

 

·        Help offset spiraling hospital costs in providing care to the uninsured; and

·        Fund a two-year, time-limited statewide enrollment of 19,283 additional Arizona children in KidsCare, a state program that provides quality, affordable coverage to children of working parents who pay monthly premiums to insure them.

 

Additionally, a large portion of the funding will be devoted to needed service and infrastructure improvements for the three hospital institutions. Phoenix Children’s Hospital plans to enhance its teaching programs, plus improve the efficiency and capacity of its pediatric Level 1 Trauma Center and Emergency Department. MIHS will develop an e-records system. UA Health Network plans to do likewise, and will establish new trauma services in a medically-underserved area.

 

“Governor Brewer recognizes the immense strain the economic downturn has put on our health care system, especially safety net hospitals,” said Bob Meyer, President and CEO of Phoenix Children’s Hospital. “Without this funding, it would be even more difficult for Phoenix Children’s Hospital to fulfill its mission to provide high quality, cost-effective care for Arizona children.”

 

“Safety net hospitals like Maricopa Medical Center play a vital role in providing health care to the underserved in our community,” said Betsey Bayless, President and CEO of the Maricopa Integrated Health System. “Hospitals like ours also bear a growing financial burden in caring for the uninsured. This plan will help Maricopa Medical Center remain a strong and growing pillar of the community.”

 

“Caring for the indigent and underserved is one of the special hallmarks of teaching hospitals like The University of Arizona Medical Center,” said Karen Mlawsky, CEO of the hospital division of The University of Arizona Health Network. “More than one-third of our patients are on AHCCCS or have no insurance at all. This proposal shows that, by working together, we can continue providing medical care to the Arizonans who need it most.”

 

The Governor’s funding plan has been submitted to the federal Centers for Medicare and Medicaid Services (CMS) for approval.

Medicare Part B premiums for 2012 lower than projected

Affordable Care Act helps keep Medicare affordable

The U.S. Department of Health and Human Services (HHS) announced that Medicare Part B premiums in 2012 will be lower than previously projected and the Part B deductible will decrease by $22. While the Medicare Trustees predicted monthly premiums would be $106.60, premiums will instead be $99.90. Earlier this year, HHS announced that average Medicare Advantage premiums would decrease by four percent and premiums paid for Medicare’s prescription drug plans would remain virtually unchanged.

Thanks to the Affordable Care Act, people with Medicare also receive free preventive services and a 50 percent discount on covered prescription drugs when they enter the prescription drug “donut hole.”  This year, 1.8 million people with Medicare have received cheaper prescription drugs, while nearly 20.5 million Medicare beneficiaries have received a free Annual Wellness Visit or other free preventive services like cancer screenings.

“The Affordable Care Act is helping to keep Medicare strong and affordable,” said HHS Secretary Kathleen Sebelius. “People with Medicare are seeing higher quality benefits, better health care choices, and lower costs. Health reform is also strengthening the Medicare Hospital Insurance Trust Fund and cracking down on Medicare fraud.”

Medicare Part B covers physicians’ services, outpatient hospital services, certain home health services, durable medical equipment, and other items. In 2012, the “standard” Medicare Part B premium will be $99.90. This is a $15.50 decrease over the standard 2011 premium of $115.40 paid by new enrollees and higher income Medicare beneficiaries and by Medicaid on behalf of low-income enrollees.

The majority of people with Medicare have paid $96.40 per month for Part B since 2008, due to a law that freezes Part B premiums in years where beneficiaries do not receive cost-of-living (COLA) increases in their Social Security checks. In 2012, these people with Medicare will pay the standard Part B premium of $99.90, amounting to a monthly change of $3.50 for most people with Medicare. This increase will be offset for almost all seniors and people with disabilities by the additional income they will receive thanks to the Social Security cost-of-living adjustment (COLA). For example, the average COLA for retired workers will be about $43 a month, which is substantially greater than the $3.50 premium increase for affected beneficiaries. Additionally, the Medicare Part B deductible will be $140, a decrease of $22 from 2011.

“Thanks in part to the Affordable Care Act, people with Medicare are going to have more money in their pockets next year,” said Centers for Medicare & Medicaid Services (CMS) Administrator Donald Berwick, M.D. “With new tools provided by the Affordable Care Act, we are improving how we pay providers, helping patients get the care they need, and spending our health care dollars more wisely.”

Today, CMS also announced modest increases in Medicare Part A monthly premiums as well as the deductible under Part A. Monthly premiums for Medicare Part A, which pays for inpatient hospitals, skilled nursing facilities, and some home health care, are paid by just the 1 percent of beneficiaries who do not otherwise qualify for Medicare. Medicare Part A monthly premiums will be $451 for 2012, an increase of $1 from 2011. The Part A deductible paid by beneficiaries when admitted as a hospital inpatient will be $1,156 in 2011, an increase of $24 from this year's $1,132 deductible. These changes are well below increases in previous years and general inflation.

For more information on how seniors are getting more value out of Medicare, please visit: http://www.healthcare.gov/news/factsheets/2011/10/medicare10272011a.html

For more information about the Medicare premiums and deductibles for 2012, please visit: https://www.cms.gov/apps/media/fact_sheets.asp

Medicare's open enrollment starts October 15

Medicare Open Enrollment – It’s Different This Year

By David Sayen

Medicare’s open enrollment season begins earlier and lasts longer this year than in the past.

Open enrollment will start on October 15 and continue through December 7.

This is the time when people with Medicare should carefully review their Medicare health and prescription drug plans.

These plans can change from year to year. Premiums can go up and drugs can be dropped. So it’s important to make sure that your plan still meets your needs in terms of cost, coverage, and convenience.

During open enrollment, you can join a plan or cancel one that no longer suits you.

A good way to shop for a new plan is to go to the www.Medicare.gov website. Click on “Compare drug and health plans.” Using the Medicare Plan Finder tool, you can plug in your zip code and see a list of plans that provide coverage in your area.

Plan Finder shows a plan’s monthly premium, deductible, whether you have to go only to doctors in the plan network, and your estimated annual health and drug costs.

The “Formulary Finder” tool on the Medicare website lets you enter the medications you’re currently taking and search for Medicare Part D plans that cover them.

Information on health and drug plans in your area also can be found in the “Medicare & You” handbook, which is mailed each fall to every Medicare beneficiary.

Or you may want to call our toll-free help line, 1-800-MEDICARE (1-800-633-4227). Customer representatives are available 24 hours a day, seven days a week, to help walk you through your health and drug plan options.

If you prefer face-to-face counseling, that’s available, too. Just call for an appointment with the closest office of your State Health Insurance Assistance Program, or SHIP.

In Arizona, the SHIP number is 1-800-432-4040. The call and the counseling are free.

The Arizona SHIP is a terrific program. Many of the counselors are Medicare beneficiaries themselves, and they can help you with a wide variety of issues – including enrollment.

The good news for next year is that we expect average premiums for Medicare Advantage health plans to be 4 percent lower than this year. Average premiums for Medicare prescription drug plans are expected to be about the same next year.

Thanks to the Affordable Care Act, people who enter the coverage gap, or donut hole, in their Part D drug plan will be able to get a 50-percent discount on brand-new drugs.

In addition, you’ll have access to preventive health services at no out-of-pocket cost. These services include cancer screenings and a new annual wellness visit with your doctor. During this visit, you and your doctor can discuss your health status and develop a personalized care plan.

We’ve also begun to rate Medicare Advantage plans based on our Five-Star Rating System. You’ll be able to see each plan’s star rating when you go on the Plan Finder.

This year, for the first time, you’ll see a gold star icon designating the top rated 5-star plans. You’ll also see warnings for plans that are consistently poor performers.

I encourage all Medicare beneficiaries enrolled in private plans to know their plan’s overall star rating and to consider enrolling in plans with high ratings. When comparing plans, you should consider the plan’s quality in addition to its costs, coverage, and other conveniences.

Part D plans also receive quality ratings. 

So don’t forget: Medicare open enrollment begins October 15 and ends December 7. The earlier time frame will allow us to process any changes you make and ensure that you have your new membership card in hand on January 1, 2012.

David Sayen is Medicare’s regional administrator for Arizona. You can always get answers to your Medicare questions by calling 1-800-MEDICARE (1-800-633-4227).

Medicare’s 2012 Open Enrollment drug and health plan data goes live Saturday, Oct. 1

Online “Plan Finder” offers unbiased resource for people with Medicare to review 2012 plan options

In advance of the new, earlier annual enrollment period, people with Medicare can begin reviewing plan benefit and cost information on Saturday, October 1st, 2011. The Centers for Medicare & Medicaid Services (CMS) will launch access to its popular web-based Medicare Plan Finder that allows beneficiaries, their families, trusted representatives, and senior program advocates to look at all local drug and health plan options that are available for the 2012 benefit year.

“With Open Enrollment coming early this year, it is important that people with Medicare take advantage of the next couple weeks to review their current coverage and compare it with the options that are available for next year,” said CMS Administrator Donald M. Berwick, M.D.  “The information that’s available now on the Plan Finder will also help caregivers, health providers, and partners that support and counsel seniors and people with disabilities in selecting the best plan for their needs.”

The annual enrollment period begins earlier this year, on October 15th, and runs through December 7th.  People with Medicare will have seven weeks to review Medicare Advantage and Part D prescription drug coverage benefits and plan options, and choose the option that best meets their unique needs. The earlier open enrollment period also ensures that Medicare has enough time to process plan choices so that coverage begins without interruption on January 1, 2012.

This year, as beneficiaries look over their available plan options, they will see better value in the Medicare Advantage (Part C) and Prescription Drug (Part D) plan benefits.  All beneficiaries will have access to Medicare-covered preventive services at zero cost-sharing, including an Annual Wellness Visit.  Those in the Part D coverage gap, or donut hole, will continue to receive 50 percent discounts on covered brand name drugs thanks to the Affordable Care Act.  On average, Medicare Advantage premiums will be four percent lower in 2012 than in 2011, and plans expect enrollment to increase by 10 percent. Average premiums for Part D prescription drug plans will also decrease to $30 in 2012, about 76 cents less compared to the average 2011 premium.  The premium amount is based on bids submitted by Part D plans for the 2012 plan year.   Benefits in 2012 remain consistent with those offered in 2011.

People can use the Plan Finder – available at www.Medicare.gov  – by inserting their home zip code to find out which Medicare Advantage (Part C) and Prescription Drug (Part D) plans are available in their areas.  If the zip code search shows multiple counties it will prompt users to select one county to continue the search.  For 2010, the Plan Finder was the most popular tool on www.Medicare.gov, with more than 280 million page views.  Also available online is Medicare’s Formulary Finder, which allows beneficiaries to insert their prescribed medications and zip code to see a display of plans offered locally that cover their drugs.

Due to provisions in the Affordable Care Act, Medicare will begin to financially reward Medicare Advantage plans which achieve high quality ratings.  Part D plans will also continue to receive quality ratings.  Beginning October 12, the Medicare Plan Finder will include each plan’s quality star rating for 2012.  For the first time this year, people who use the Plan Finder will also see a gold star icon designating the top rated 5-star plans, and will continue to see warnings for those plans who consistently are poor performers. “We encourage all Medicare beneficiaries enrolled in private plans to know their plan’s overall star rating and to consider enrolling in plans with high ratings,” said Jonathan Blum, CMS Deputy Administrator and Director, Center for Medicare. When comparing plans, beneficiaries should consider the plan’s quality in addition to its costs, coverage, and other conveniences. On October 15, people with Medicare will be able to make informed decisions when they select their plan for the coming year.

More information is available at www.healthcare.gov, a new web-based portal brought to you by the U.S. Department of Health & Human Services.