The 2010 annual enrollment period for individuals with Medicare plans ends Dec. 31. Specialists at Health Plan One, an online insurance brokerage and Medicare information portal, explain the top three most discussed topics among seniors:
What is the difference between Medigap and Medicare Advantage? – While Medigap and Medicare Advantage plans provide seniors additional coverage on top of Medicare Part A and Part B coverage, they offer uniquely different benefits. While Medigap – or Medicare supplement plans – typically have higher monthly premiums, these plans pay a member's share of the costs of Medicare-covered services thus eliminating or reducing out-of-pocket payments, including coinsurance, deductibles, preventive services and at-home recovery services. Enrollees would have to purchase a stand-alone Part D drug plan.
Under Medicare Advantage, seniors typically have lower monthly premiums with a Part D drug plan included but have some out-of-pocket expenses. They also have incentives for staying in health insurers' provider networks. Seniors also receive value-added benefits, including discounts on gym memberships, health and wellness service and a variety of discount programs, at no additional charge.
Recommended For You
"As seniors continue to worry about their financial stability and their ability to pay for needed health care, the questions around medigap coverage have soared. While individuals like the Medicare Advantage benefits, some are willing to forgo these and pay more for the safety net offered through the supplement plans," said Bill Stapleton, president and chief executive officer of Health Plan One. "In the case of Medigap plans, price should guide your decision since benefits are identical. However, some states do allow for different pricing based on age and gender."
Why did my Medicare Advantage plan get cancelled? – Health insurers withdraw plans for a variety of reasons, including the introduction of similar plans or an inability to meet CMS enrollment thresholds. For 2010, many insurers cancelled their private fee-for-service (PFFS) plans in anticipation of the termination of all PFFS plans after December 31, 2010. When insurers cancel plans, those members may be automatically enrolled in a similar plan; however this "automatic roll-over" does not mean that seniors cannot choose other plans that are more suited to their needs, even if that means opting for other carriers. Contact a local health insurance broker or visit plan comparison sites like www.medicaresolutions.com to obtain information on other available options.
"We are surprised to be getting this question so late in the enrollment season, but individuals now may be realizing that they are not locked in to the choices that the health plans have made for them," said Stapleton. "Again, there is still plenty of time to make changes for 2010. In addition, beginning January 1 through March 31, there is a special enrollment period where seniors – under select circumstances – may make additional changes to their coverage."
Why is my Medicare Advantage premium going up? – The primary reason why health care premiums and out-of-pocket cost rise is that medical costs increase at a faster rate than government payment increases to health insurers. If premiums are an issue, seniors can compare insurance plans to find a more economic option. However, since cost is not the only issue when selecting a plan, research provider networks and drug coverage available under Part D offerings before making any final decisions.
© 2025 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.
