Medicare Advantage Enrollment For 2012 Plans

Each year Medicare beneficiaries can either enroll in or switch Medicare Advantage plans during the Annual Enrollment Period. At this time you are free to do as you see fit. You can join, drop or switch plans. Your window of opportunity is limited and if you miss it you may lose your opportunity to make changes. In previous years the Annual Enrollment Period began November 15 and ended December 31. Often times people would loss their chance due to procrastination and getting caught up in the festivities of the holidays seasons.

The Annual Enrollment Period for Advantage plans with a January 2012 effective date will begin October 15, 2011 and end December 7, 2011.This will increase the time frame allowed to make changes and avoid the end of the year holiday season for many. The down side of this change is that there will be many uninformed people who will miss their opportunity to make changes to their Medicare Advantage plan. Missing the Annual Enrollment Period can mean any one of the following:

• If you are enrolled in Medicare only you may not be able to enroll in a Medicare Advantage plan.


• If you are enrolled in a Medicare Advantage plan and it renews for 2012 you will remain in that plan.


• If you are enrolled in a plan that does not renew you will be granted a Special Enrollment Period granting you a short extension.

It should be noted that the Annual Enrollment Period is not the only time that changes can be made. A Special Enrollment Period may be granted due to a change in circumstances. Circumstances include but are not limited to; first becoming eligible for Medicare, moving from a plan's service area and losing credible employer group or union coverage. Also, if you receive extra help financially with Medicare or Medicare Part D you are granted a Special Enrollment Period.

Nothing frustrates Medicare Advantage plan members more than finding that they are virtually locked into their Medicare Advantage plan. Unless you take advantage of the annual dis-enrollment period which runs from January 1 through February 14 or are entitled to a Special Enrollment Period you generally are locked in for the full calendar year.

New Special Enrollment Period for 2012

The Centers for Medicare and Medicaid Services (CMS) has established a new Special Enrollment Period for people to enroll in a 5 star rated plan at anytime during the year. Eligibility requirements are fairly straight forward. The include:

• You must have Medicare Parts A and B.


• You must live in the plan's service area.


• You must not have end-stage renal disease.


• You are enrolled in a Medicare Advantage plan with 4.5 stars or less.


• You are enrolled in original Medicare and meet the requirements for Medicare Advantage.

This is good news for those people who qualify but unfortunately 5 star Medicare Advantage plans are few and far between. Most people are enrolled in a Medicare Advantage plan with less than 4.5 stars but in some service areas (mostly rural) there may be only a couple of Medicare plan options to begin with. If you have few plan options and none are 5 star plans this will increase your feelings of being dis-advantaged (no pun intended!).

Why a 5 star plan may not be right for you

Just because CMS has assigned a plan a 5 star rating it doesn't mean that it is necessarily your best choice. You still need to take into consideration the specific features of the plan as it relates to your circumstances. As with all plans, your health and budget play a major role in choosing the right plan. Two features that are important to consider include:

• The plan's network.


• The drug plan formulary if Part D is included.

Another unintended consequence of this Special Enrollment period may actually mean that you have fewer plan options going forward. If enough people leave a plan rated at 4.5 stars or below mid-year it may mean those plans become less profitable and less viable for the plan's sponsor to renew the plan for the following year.

If you are interested in changing plans at anytime this may or may not be a solution for you. To learn if you have 5 star rated plans available visit the Medicare website to search for plans in your area.

1. Start early. It's easy to procrastinate, but this is one instance where it can be detrimental. The last application submitted during the Annual Enrollment Period is the one that counts. In other words, if you submit an application early and then find a plan you believe would be better, you can submit an application for that plan and it will be the one that becomes effective January 1. And there's no need to notify the first company, that is all done through CMS.

2. Compare multiple plans. Medicare Advantage plans are not offered as standardized Medicare plans like Medicare supplement policies. The network, benefits and monthly premiums can all vary form plan to plan.

3. Review your current plan. Even if you have been satisfied with your current plan it makes sense to look at the new plan being offered for the following year. Insurance companies that participate in the Medicare Advantage program can renew a plan but make changes to benefits and premiums. Networks also lose providers from time to time. Some plans may not renew for the following year. Even though it seems like an endless stream of mail from your current plan, read everything to ensure that your plan is not being dis-continued in your County.

4. Don't compare plans on monthly premium alone. There are too many moving parts in a Medicare Advantage plan. When analyzing the financial aspects of the plan consider co-payments, deductibles and co-insurance amounts. Saving a couple dollars on monthly premium could cost you hundreds if you make the wrong choice based on your circumstances.

5. Ask for help. Although you can enroll online or over the phone, don't rule out the benefit of using a licensed agent who is familiar with and approved to enroll you in the plan you are interested in. A trusted agent can be worth their weight in gold if you have service issues after you become a plan member.

This information should bring you up to speed on changes to Medicare Advantage enrollment for 2012. If you plan on enrolling in a Medicare Advantage plan mark your calendars for the new dates and let others on Medicare know about these changes. If you have 5 star plans available and are interested in changing plans mid-year be sure to do your homework and look at all aspects of the new plan.

The Medicare Advantage program seems to be in a constant state of flux. To keep up to date on topics related to Medicare, Medicare Advantage, Medigap and Part D you can find hundreds of articles at Medicare Plan Review. Medicare Plan Review is not owned or operated by an insurance company and none of your personal information is required to benefit from this valuable resource.

Visit Medicare Plan Review