2012 Part B Premium

CMS recently released the rate for the 2012 Part B premium.  The rate for next year will be $99.90 per month.  For many beneficiaries, those enrolled in Part B prior to 2009, this represents a $3.50 increase (3.6%) - the first increase since 2009.  For anyone who enrolled in Part B subsequent to 2009, these rates are lower than the 2011 rates.  For instance, a person who enrolled in Part B during 2011 has been paying $115.40 per month.  If you're one of these people, break out your party pants because you just got a $15.50 per month (13.4%) decrease!

For a full chart of the 2012 Part B premium rates, click here.

2012 Baseline Prescription Drug Plan

CMS has recently released the 2012 advised structure for all prescription drug plans.  While each company may design their plan in any way they choose, they must be at least "actuarially equivalent" to this standard design.  That is, they cannot offer coverage that, all things considered, is less than the standard coverage. 

The changes of note from last year are...

• Deductible change from $310 to $320
• Donut Hole threshold change from $2,840 to $2,930
• Generic discount during the Donut Hole increased from 7% to 14%
• Catastrophic Coverage threshold change from $4,550 to $4,700

To see a full breakdown of the 2012 standard plan, click here.

Medicare Enrollment Periods for Plan Year 2012

This year changes have been made to the Medicare Enrollment Periods.  What is a Medicare Enrollment Period?  If you are enrolled in a Medicare Advantage Plan or a Prescription Drug Plan, there are only certain periods during the year in which you may make changes to your plans.  Baring any special circumstances these periods are as follow:

• Annual Election Period: Oct 15th - Dec 7th. During this period you may enroll or disenroll from a Medicare Advantage Plan or a Prescription Drug Plan. All changes during this time will be effective Jan 1st.


• Medicare Advantage Disenrollment Period: Jan 1st - Feb 14th. During this time period you may only disenroll from a Medicare Advantage Plan and return to Original Medicare. You may add a Prescription Drug Plan to replace the drug coverage that your Medicare Advantage Plan afforded.

There are small nuances to the above periods, as well as many other "Special Election Periods" If you feel that you may have a special circumstance that would allow you to enroll or disenroll from a Medicare Advantage Plan or Prescription Drug Plan and you would like to speak with us more about your potential options, please feel free to call (800-817-98223) or email (info@tweedyinsurancegroup.com) us anytime.

The Shrinking Donut Hole

Beginning this year, the Patient Protection and Affordable Care of 2010 has gone into effect that will begin to shrink the infamous Medicare Part D Coverage Gap - more commonly known as the "Donut Hole". Part D Prescription Drug Plans help pay cots for medications at different rates based on four different phases: the deductible, phase 1, the coverage gap, and catastrophic coverage. The deductible, which some plans do not have, is generally no more than $325 per year. After this deductible, the plan begins paying the bulk of the cost of your prescriptions, leaving you with a smaller copay or coinsurance. However, once the total retail cost of your medications reaches a certain level ($2,840 in 2011) you enter the Donut Hole begin paying 100% of your medications. The plan will begin helping with the cost of your medications again once you cross the Catastrophic out-of-pocket threshold level ($4,550 in 2011). That means that for approximately $3,600 per year, you are on your own.

Or, should we say, were on your own. Beginning this year Part D members will receive discounts on their medications when they enter the Donut Hole. In 2011, generics will be discounted by 7%, and brand-name medications will be discounted by 50%. These discounts are set to increase over the next nine years until there is a 75% discount on both generics and brand-name medications. To see a chart that depicts this Donut Hole phase-out click here.