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For most Medicare beneficiaries who are enrolled in a Medicare Advantage Plan, the answer is “no.” In fact, the Centers for Medicare & Medicaid Services announced in Sept. of 2010 that the 2011 Medicare premiums for beneficiaries with Medicare Advantage Plans should decrease by approximately 1 percent.

In addition to reduced Medicare premiums, beneficiaries with Part C Medicare coverage will see positive changes in their Medicare benefits thanks to the 2010 Patient Protection and Affordable Care Act. These include expanded services and reduced out-of-pocket expenses. Medicare copays are expected to vary depending on Medicare coverage.

Switching Plans
Beginning in 2011, Medicare will no longer offer the Jan. 1 through March 31 open enrollment period. Under most circumstances, this means beneficiaries will be required to keep whichever Medicare Advantage Plan they are enrolled in on Jan. 1 for the rest of the calendar year. Certain exceptions apply, and from Jan. 1 through Feb. 14, beneficiaries may elect to de-enroll in their Medicare Advantage Plans and enroll in Original Medicare instead. If a beneficiary is enrolled in a plan that increased Medicare premiums in 2011, the beneficiary may decide that a switch to Original Medicare is the best move. Additional information about switching to Original Medicare from a Medicare Advantage Plan can be obtained by calling 1-800-MEDICARE (TTY 1-877-486-2048).

Medicare beneficiaries will be able to join a new plan or switch from one Medicare Advantage Plan to another during the 2011 Annual Enrollment Period. Unlike in previous years when the Annual Enrollment Period ran from Nov. 15 to Dec. 31, the 2011 Period will begin in Oct. and end Dec. 7. There are numerous Medicare Advantage Plans offered by private insurance companies to Medicare beneficiaries nationwide. Beneficiaries may choose between Health Maintenance Organization (HMO) Plans, Preferred Provider Organization (PPO) Plans, Private-Fee-For-Service (PFFS) Plans, and Special Needs Plans.

With the variety of plans available, beneficiaries should spend time comparing their options. The plans’ Medicare premiums and Medicare copays are important aspects to consider during comparison. It is also important to remember that the number of people enrolled in a plan, the services most requested by the plan’s beneficiaries, the cost to provide medical services in the beneficiaries’ counties, and a number of other factors can all cause Medicare premiums to vary from year to year.

Plan Access
Nearly 25 percent of all Medicare beneficiaries, 11.8 million people, were enrolled in a Medicare Advantage Plan in 2010. Industry experts expect at least a 5 percent increase in enrollment in 2011. Depending on where they live, beneficiaries who wish to enroll in a Medicare Advantage Plan in 2011 will have, on average, approximately 24 plans from which to choose. Some areas may have significantly more. The vast majority of counties will have at least 10 different Medicare Advantage Plans.

As in previous years, HMO Plans are expected to remain the most common type of Medicare Advantage Plan, with at least 50 percent of Medicare Part C beneficiaries enrolled in one. The number of PFFS Plans available is expected to drop by almost 50 percent nationwide in 2011. The number of SNP Plans available is also expected to decline between 2010 and 2011.

The specific Medicare benefits available to a Medicare Advantage Plan beneficiary, including Medicare premiums and Medicare copays, will depend on the beneficiary’s plan and residence.

Medicare Premiums for Drug Coverage
Medicare premiums for prescription drug coverage, included as part of a Medicare Advantage Plan, are expected to be an average of $50.61 per month. This is almost a $5 decrease from 2010 premiums, which averaged $55.86. As in prior years, the 2011 Medicare premiums for drug benefits for beneficiaries with Part C Medicare coverage will be least expensive under an HMO Plan (average Medicare premium is expected to be $36.24 for 2011) and most expensive under a Cost Plan (average Medicare premium is expected to be $131.18 for 2011). Medicare premiums for prescription drug benefits under PPO plans will likely range between $50 and $70 per month. The vast majority of Medicare beneficiaries will have access to at least one Medicare Advantage Plan that offers prescription drug coverage at no additional premium.

Out-of-Pocket Costs and Medicare Copays
In 2011, in order to meet new requirements included in the 2010 healthcare reform bill, all Medicare Advantage Plans will feature annual out-of-pocket maximums. In the past, many plans provided no such limits. By law, the maximums cannot be greater than $6,700, and the Centers for Medicaid & Medicare Services has encouraged providers to offer Medicare coverage with out-of-pocket limits set at $3,400 or less.

Plans that offer Medicare coverage with reduced Medicare copays often charge higher monthly premiums. Which option will result in the most cost savings will depend on how often a beneficiary receives medical treatment. Those who have a frequent need for medical services may choose to go with a higher monthly premium in order to receive lower Medicare copays.

Extra Help
Low-income subsidies may be available for Medicare beneficiaries who have a difficult time paying for their prescription drug coverage. Extra Help is a Medicare program for beneficiaries with low income and limited resources. Any beneficiary who receives full Medicaid benefits and/or receives Supplemental Security Income automatically qualifies. Medicare copays for beneficiaries who receive Extra Help are expected to be approximately $2.50 for each generic drug purchased and $6.30 for each brand-name drug purchased. Additional help paying monthly Medicare premiums for Part B Medicare coverage may be available through state Medicaid offices.

For more information, call 1-800-MEDICARE (TTY 1-877-486-2048).