Explaining What’s New in Medicare 2011

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Ohio seniors on Medicare anticipate new benefits and changes due to the Affordable Care Act:

First of all, Original Medicare will cover the cost of one wellness visit with your doctor per year.

A yearly check-up will include routine measurements like your blood pressure, a review of your prescriptions and medical history, and an assessment of any risks to your physical and mental health.
Until now, Ohio Medicare recipients only received a one-time preventive exam, the “Welcome to Medicare” exam during the first year you sign up for Medicare Part B coverage.
If you’re enrolled in a private Ohio Medicare Advantage health plan, check with your insurer about whether your wellness visit will be covered at no cost in 2011.

Your Ohio Medicare premiums will most likely change.

Most people on Medicare will pay the same Part B premiums this year as they did in 2010 – either $96.40 or $110.50 per month.
But there are several exceptions.
If you enroll in Part B for the first time in 2011, or if your premiums aren’t deducted from your Social Security check, you’ll pay $115.40 a month.
For higher-income beneficiaries (single people with annual taxable incomes over $85,000 or married couples with incomes above $170,000), Part B premiums will range from $161.50 to $369.10.
Also starting this year, Ohioans in those income brackets will pay a monthly surcharge of $12 to $69.10 for their prescription drug coverage.

If you have an Ohio drug plan and reach the coverage gap, or “donut hole,” you’ll receive a discount on your prescriptions.

Ohio Medicare enrollees get 50 percent off the price of brand-name drugs and 7 percent off generics while in the “donut hole.”
Even though you’ll pay less for a brand-name drug, you can count the prescription’s full price toward the amount you’re required to spend on drugs to qualify for catastrophic coverage.
That way, you’ll enjoy lower out-of-pocket costs while in the “donut hole,” but you’ll still become eligible for Medicare’s catastrophic coverage as quickly as you would without the discount.

If you have Original Medicare, you’ll pay nothing out of pocket for most preventive services.

Without an Ohio Medicare Supplement, you’ve usually paid 20 percent of the Medicare-approved amount for lab tests and screenings after you met your annual deductible.
But starting in 2011, you don’t have to worry about a deductible, co-payment or coinsurance for a broad range of preventive services.
Included are Pap tests, colonoscopies, mammograms, prostate cancer screenings!

Explaining New dates for changing your Ohio coverage.
We now have more time to choose and join a private health or drug plan when the annual open enrollment period gets an earlier start than usual in the fall.
This year, it will kick off on Oct. 15 and wrap up on Dec. 7.
If you want or need to change your private Medicare Advantage health plan, there’s a new annual “disenrollment” period allows you to switch back to Original Medicare and a drug plan between January 1 and February 14.
This replaces a January-to-March enrollment period when you could switch between Original Medicare and the Medicare Advantage program or move from one private plan to another.  The best way to understand what’s new is to refer to your “Medicare and You 2011” handbook, which you should have received by mail this fall.
If you still need one, call 1-800-MEDICARE and request a free copy, or visit our guidebook page and download it.