Medicare is a national health insurance plan for people age 65 and older, people under the age of 65 with certain disabilities, and people with end-stage renal disease.
Here's the latest:
The Good: The new federal health reform law lowers premiums and cost-sharing for those enrolled in traditional Medicare, and will result in savings of more than $3,500 per person over the next 10 years, federal officials say.
For 2011, beneficiaries will have lower prescription-drug costs through a 50 percent discount on brand-name drugs in the Medicare coverage gap, which is also known as the "doughnut hole," as well as wellness checkups, and no co-payments for preventive care.
The Bad: Medicare enrollment started Nov. 15 and ends Dec. 31, so seniors and others who are eligible must spend their holidays weighing the pros and cons of numerous plans - 27 Medicare Advantage replacement plans and 30 Part D Medicare prescription plans in Southern Arizona, for example.
People are also reading…
And a change from previous years: There will be no opportunity to change Medicare Advantage plans between January and March as there had been in the past.
The Ugly: Federal sanctions against three insurance companies mean they will not be allowed to accept any new Medicare enrollees.
The biggest of the companies affected is Health Net. About 660,000 Medicare beneficiaries are enrolled in the organization's national and local plans, including about 85,000 in Arizona. The ban took effect Nov. 20, so anyone who enrolled before that time should be okay.
Health Net's violations were identified during an audit. Federal officials say the company improperly administered the Medicare drug benefit in its national prescription drug plan and local Medicare Advantage prescription drug plan contracts.
In addition to Health Net, the federal agency also imposed sanctions on Medicare Advantage plans sponsored by Arcadian Management Services of Oakland, Calif., and Universal American Corp. of Houston, Texas. The marketing and enrollment suspension for Arcadian and Universal American will be effective Dec. 5.
The sanctions will remain in effect until the companies "demonstrate to CMS (the U.S. Centers for Medicare & Medicaid Services) that they have corrected the related deficiencies and that those deficiencies are not likely to recur."
Universal American has 300,000 enrollees in its Medicare Advantage plans nationwide, including 1,900 in Arizona. Sanctions were not imposed on its national stand-alone prescription drug plans. Company officials said they are working to resolve the issues with CMS as quickly as possible.
Arcadian has 66,000 enrollees in Medicare Advantage plans in 15 states, primarily Texas and Arkansas. Information on Arizona enrollees was not available.
Confused?
Medicare enrollees may call 1-800-MEDICARE with questions
