Medicare Open Enrollment: find comfort in convenience

By Jonathan Blum, Acting Principal Deputy Administrator and Director of the Center for Medicare

Like most people, I take comfort in the things I’m familiar with. I choose to shop at the supermarket around the corner because I know exactly where to find the things I’m looking for. Sure, I might be able to save a little more money by shopping at a different store on the other side of town, but I choose to stick with what I’m most comfortable. We all like to get a good deal, but convenience is a big part of the value.

The same is true when it comes to choosing a health plan: convenience matters. So in addition to cost, coverage, and benefits, here are some other things you may want to consider as you compare Medicare options during Open Enrollment:

Doctor and hospital choice

You want to be comfortable with the people you’re working with, especially when it comes to something as private as your health. Will your doctors and hospitals accept your current coverage next year? If you’re thinking about changing plans, make sure you check which doctors and hospitals you’ll be able to use. Where are they located, and what are their hours?

Pharmacy access

Is the pharmacy you use included in your drug plan’s network? Do they prescribe electronically? Can you get refills by mail? Remember that plan networks can change from year to year. If it’s important to you to stay with the same pharmacy, it’s worth checking to make sure they’ll still be in your plan’s network.


Maybe you travel a lot, or spend part of the year in a different state. If you do, make sure you know whether your coverage will travel with you.

We’re working hard to make sure you have choices in the way you get the Medicare benefits you’ve earned – and we want you to be comfortable. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area. If you still need help comparing, call 1‑800‑MEDICARE (1-800-633-4227).

2013 Medicare update

By: Marilyn Tavenner, Acting CMS Administrator

We’re now past the halfway point for Medicare’s annual Open Enrollment period, which opened on October 15 and closes December 7. As you and your loved ones with Medicare sit down to consider your options for 2013, we’d like to share the latest news about Medicare. 

Our Administration is committed to making Medicare stronger for you and future generations. Thanks to the health care law, everyone on Medicare can get preventive services like mammograms and other cancer screenings for free. The health care law also makes prescription drugs more affordable for seniors who hit the donut hole.

These new benefits are making a difference for millions of Americans. 5.6 million seniors and people with disabilities have saved $4.8 billion on prescription drugs since the law was enacted, and during the first nine months of 2012 over 20.7 million people with original Medicare got at least one preventive service at no cost to them. 

These and other parts of the law will result in significant savings. We estimate that the health care law will save the average person in traditional Medicare $5,000 through 2022Earlier this year we projected that the standard premium for Medicare Part B (which covers certain doctors’ services, outpatient care, medical supplies, and preventive services) would rise by more than $9.00 a month in 2013. Today we announced that the actual rise will be lower—$5.00—bringing 2013 Part B premiums to $104.90 a month. By law, the premium must cover a percent of Medicare’s expenses; premium increases are in line with projected cost increases.  Medicare Part B premiums have gone up slowly over the past five years – an average of less than 2 percent a year, or $8.50 total.

Several other changes in 2013 include:

  • Medicare Part A Premium: Part A covers inpatient hospital stays, care in a skilled nursing facility, hospice care, and some home health care. Only about 1 percent of people with Medicare pay a premium for Part A services—you need to have paid Medicare payroll taxes for 40 quarters of employment or be married to someone who did. For those few affected, the 2013 Part A premium is decreasing to $441, down from $451 in 2012.
  • Medicare Part A Deductible: This deductible is the cost to people with Medicare for up to 60 days of Medicare-covered inpatient services in the hospitals for each benefit period (a benefit period starts the day a patient is admitted and ends when the patient has been out of the hospital for 60 days in a row.)  This will increase to $1,184 in 2013, up from $1156 this year (an increase of 2.4%).
  • Medicare Part B Deductible: The deductible will increase to $147 in 2013, from $140. This is still $15 below the deductible in 2011.  
  • Income-related Adjustments: People with Medicare who report 2011income above $85,000 a year ($170,000 filing jointly) are legally responsible to cover a larger portion of the cost of their coverage.  These premium adjustments range from $42.00 to $230.80 a month for Medicare Part B.

As Open Enrollment finishes up and we approach a new year, people with Medicare can be assured they are part of a program that strives to deliver better benefits while curbing costs. And we will continue to do all we can to make Medicare even stronger.

Medicare Open Enrollment: More is better

By Jonathan Blum, Acting Principal Deputy Administrator and Director of the Center for Medicare

In this season of Open Enrollment, people with Medicare have the opportunity to choose the Medicare plan that best serves their unique health needs and provides them with the greatest value. In determining the value of a plan choice, you should look not only at premiums and cost-sharing but also at what benefits and quality of care that money will buy. This year, I am proud to say that while costs, by and large, have remained relatively stable, the benefits that people with Medicare will get for their premiums continues to grow.

For those choosing Original Medicare, the benefit package continues to grow stronger and provide greater value. For example, EVERYONE with Medicare has access to a variety of preventive services and screenings, most at no cost to them when furnished by qualified and participating health care professionals. This includes things like diabetes and cancer screenings, and a yearly “wellness” visit. During the first 9 months of this year, over 20 million people with Original Medicare received at least one preventive service at no cost.

Beneficiaries may also explore their options beyond Original Medicare, as virtually all people with Medicare have access to Medicare Advantage Plans in 2013, and many of these plans offer extra benefits beyond the comprehensive package offered by Original Medicare. Medicare Advantage Plans may offer vision, hearing, or dental coverage, or extend coverage while you travel. And most Medicare Advantage Plans also include prescription drug coverage.

Use this time to decide what benefits are most important in helping you meet your unique health care needs. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area for what will provide you with the greatest value. If you still need help comparing, call 1 800 MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Only you know what extra benefits and services are most important for you. Just know that no matter how you choose to get your Medicare benefits, you’ll be getting more.

Stay up to date on the latest Medicare news and follow us on Twitter @Medicaregov.

Medicare Open Enrollment: What’s your back-up plan?

By: Jonathan Blum, CMS Acting Principal Deputy Administrator and Director, Center for Medicare

We all like to plan ahead – whether it’s planning for a road trip next summer or planning a big family get-together. Despite our best planning, uncertainty is a fact of life. We always need a back-up plan. What if the car breaks down?  What if it snows on the day of the get-together?

Nobody likes to think of back-up plans when it comes to our health, but health can be as unpredictable as the weather. It’s hard to know what you’ll feel like next week, much less what health care you’ll need next year. But that’s exactly what you need to think about when you’re shopping for health coverage during Medicare Open Enrollment – which ends on December 7.

Even when future needs can be hard to forecast, taking stock of your current situation can help. Review your prescription drug needs, and look for a plan that meets those needs. Plans may vary in what drugs they cover, and some may have special rules that you must follow before they cover a drug.

You may have other health insurance from a current or past job, or through a family member. If you do, you’ll want to understand exactly how that other coverage works with Medicare. You may decide to keep what you have now – and that’s ok.

It’s worth your time to take a look and compare coverage. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area. If you still need help comparing, call 1‑800‑MEDICARE (1‑800‑633‑4227). TTY users should call 1-877-486-2048.

While you can’t predict everything in life, you can do your best to be prepared. Medicare will be there, stronger than ever, to help.

Stay up to date on the latest Medicare news and follow us on Twitter @Medicaregov.

Medicare Open Enrollment: Be a smart shopper

By: Jonathan Blum, CMS Acting Principal Deputy Administrator and Director, Center for Medicare

In today’s world, we’re all a little more conscious of costs. Maybe we clip a few more coupons, eat out less, or compare ads to find the best price on something before we buy. Cost is an important factor in any purchase, and health care is no different. We know you want to get the best value possible from your health care coverage. Wouldn’t most of us like to get more and pay less for things that are important to us?

The good news is the health care law has gone a long way toward lowering overall costs in the Medicare program. Average premiums for prescription drug coverage and Medicare health plans will stay around the same in 2013. People who are in Medicare’s prescription drug coverage gap (“donut hole”) will continue to save money in 2013 with big discounts on brand-name prescription drugs. Since the health care law was enacted in 2010, more than 5.5 million people with Medicare have saved nearly $4.5 billion on prescription drugs in the donut hole. 

But you still need to make smart choices to get good value out of your health insurance.

There may be dozens of Medicare plans in your area, all with different costs and levels of coverage. Ask yourself:

  • How much are each plan’s premiums and deductibles?
  • How much will I pay for the benefits and services I’m likely to use?
  • Is there a limit on what I’ll have to pay out-of-pocket for the year?
  • Does the plan cover the drugs I take?
  • How much will my prescriptions cost under each plan?

Only you can determine what mix of benefits and costs will work best with your needs and budget. Shopping around can make a huge difference, and we want to help. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area. If you still need help comparing, call 1‑800‑MEDICARE (1-800-633-4227). TTY users should call 1-877-486-2048.

Whether it’s groceries, health insurance, phone plans or anything else, we all want the best value for our dollar. Make sure you have the most up-to-date information out there and be a smart shopper during Medicare Open Enrollment – which ends on December 7.

Medicare Open Enrollment: Now’s the time!

By: Marilyn Tavenner, Acting Administrator

 It’s picking season – pumpkins, apples, Halloween candy…and a Medicare health or drug plan. Today is the start of Medicare Open Enrollment!

In my work with Medicare, one of the questions people ask me often is which plan is the best one. That’s not something I can answer, because picking a plan is an important and personal decision. Each person has a unique set of priorities. How do you weigh your options? Now’s the time to think about what matters to you, and pick the Medicare plan that meets your needs.

When you sit down to review your Medicare health and drug plan choices this year, keep track of the things you may want in a plan, and pick one that’s right for you. Here are some things to keep in mind while you consider your choices:


You should look at your current health care costs to find coverage that works with your financial situation. How much are your premiums and deductibles? How much do you pay for hospital stays and doctor visits? Just like with everything else, the lowest-premium health plan option might not be the best choice for you.


Are the services you need covered? We know future health care needs can be hard to predict, but changes happen. Maybe your doctor changed your prescriptions this year or you have different health concerns. Make sure you understand what services and benefits you’re likely to use in the coming year and find coverage that meets your needs.


Your time is valuable. When comparing plans, make sure you check which doctors and hospitals you’ll be able to use. Where are they located and what are their hours? Check which pharmacies you can use. Can you get prescriptions by mail? Remember that even if you’re happy with your current plan, these answers might change from year to year.

Quality of care

Ask yourself whether you’re truly satisfied with your medical care. Not all health care is created equal, and the doctors, hospitals and facilities you choose can impact your health. Look for plans with a 5‑star performance rating — the right expertise and care may help speed your recovery and improve your outcomes.

 It’s worth your time to take a look and compare coverage between now and when Open Enrollment ends on December 7. Use the Medicare Plan Finder to look at all of the health and drug plan options in your area. If you still need help comparing, call 1‑800‑MEDICARE (1‑800‑633‑4227).  

Only you know what’s most important to you and your family – that’s why I want to make sure you have all the information you need to make the best decision. Before you consider your Medicare plan options, think about your personal priorities so you can be sure your plan meets your unique needs.

 Stay up to date on the latest Medicare news and follow us on Twitter @Medicaregov.


Put it on your fall checklist: Medicare Open Enrollment

By: Julie Green Bataille, Director of Communications

If you’re like me, fall is an extremely busy time of year—getting the kids ready for a new school year, making sure everyone in my family gets a flu shot, getting the house and yard ready for the winter. With everything we have going on, it’s so easy to forget another activity that should be on all our fall checklists: Helping our parents prepare for Medicare Open Enrollment.

Medicare Open Enrollment gives beneficiaries the chance to review their health and prescription drug coverage for the coming year. If they need to make any changes, they can do so between October 15 and December 7. But if they decide that they’re happy sticking with the coverage they have now, they don’t need to do anything else.

For all of us who are caregivers, or who just care about older parents and family members, we need to ensure that they have the right information to make the right choice. Sit down and have a conversation with them, and help them explore their options and find coverage that fits their needs.

If your parents want to go online and sort through the details, they can get an early start, and you can help them navigate the process if needed. We’ve already made sure that the Medicare Plan Finder is fully updated with all new 2013 cost and benefit information for health and drug plans and is ready right now. All your parents need to do is start by entering the drugs and checking on the doctors and pharmacies they want to use. A few more steps will get them a personalized list of their plan choices and help them compare.

Between now and December 7, your parents will be hearing more about the choices, benefits, and lower overall costs they’ll have when it comes to Medicare. We’ll also be adding tips and advice to this blog, to help them you and them consider and weigh choices, and to find places to go to get help if needed.

When Medicare Open Enrollment ends on December 7, we want every single person with Medicare to have health and drug coverage that meets their needs. But we need your help. We need you to help ensure that your older family members have the right health plan.  So when you’re preparing your fall checklist, don’t forget to put Medicare Open Enrollment at the top.

Stay up to date on the latest Medicare news and follow us on Twitter @Medicaregov.