Thursday, October 24, 2013

It's Our Favorite Time of the Year

Well, not really, but the title did get your attention didn't it?  It is that time of the year though--the Medicare open enrollment time of the year. The time when the newspapers are running page-length advertisements for various Medicare Advantage and drug plans and there are a fair number of articles about Medicare. I'm not sure my students read print newspapers anymore, and may not have time to read the on-line versions either. But I tell them to take a look for these ads, so they get a sense of the Medicare "cycle" if you will.  We know, in addition to open enrollment, CMS also releases the next year's dollar figures for original Medicare as well as the Part D stand-alone plans.

The Kaiser Family Foundation  (one of my favorite go-to sites for information on health care) released an October 2013 issue brief by Jack Hoadley, Juliette Cubanski, Elizabeth Hargrave and Laura Summer on Medicare Part D: A First Look at Plan Offerings in 2014.   The report has a lot of good detail, statistics and charts. The key findings from the report are a quick and useful way to integrate current data into our course materials. Kaiser released another October 2013 brief by the same authors, along with Patricia Neumann, titled To Switch or Not to Switch: Are Medicare Beneficiaries Switching Drug Plans To Save Money?

The Medicare site for beneficiaries, has some interactive features for beneficiaries looking to learn more about their current coverage and options in their geographic areas. I like to show my students the interactive features and have them search for plans in their area and compare them, so they have a good idea what issues beneficiaries face in making informed decisions.

So, let's just remind ourselves that we have another 6 weeks or so of the ads for the different plans, and by then, it will be another one of our favorite times of the year...

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I’m just an ordinary citizen (CCRC resident; Medicare participant; Babyboomer), so I’m talking from the bleacher seats. It’s my prediction (and hope) that one of these days the medical community, the insurance carriers, and the government will realize that having the entire population tied to the SAME calendar year for Open Enrollments, deductibles, and medical appointments/procedures makes no sense. This includes Medicare and group insurance. The medical insurance I had for my dogs made more sense. I purchased their plan in March, with an April 1 effective date. The premium schedule was for April 1 – March 30. The deductible year was April 1 – March 30. I eyed the calendar when scheduling follow-up appointments, but at least I was doing this in March and NOT competing with everyone else trying to do things in December.
In our current society, there is too much stress put on the systems in late fall for all the January 1 effective date. Plus, the medical community comes under stress also, as people who have met their deductible for the current (calendar) year try to “get other things done” prior to December 31. Or, if they have NOT met their deductibles, they’ll schedule elective procedures for January of the next year to get the maximum benefit for that new year, knowing they’ll meet their deductibles early on.
We think December is a difficult month because of the holiday season? Not. It’s the Benefits Departments trying to get straggling Open Enrollment documents turned in; it’s Payroll Departments trying to make the last payroll run of the tax year capture everything it is supposed to (examples: year-end bonuses and one-time extra withholding); it’s Accounting Departments trying to get transactions done so they’re booked by the close of the year; it’s the hospitals and doctors’ offices trying to accommodate anxious patients. Geez.
If everyone had insurance like my pets’ insurance, the effect of all of the above-mentioned “problems” would be distributed evenly over the months. So what if Medicare premium rates and deductibles change on January 1? A good software system (hmmm…. wonder if the government can come up with one that would work?) can pro-rate the new premiums and deductible amount for the participants renewing for the other eleven months. Those “renewing” for an August 1 renewal date (with an August 1 – July 31 premium year and deductible year) would have their own unique August 1 – July 31 premium rate and deductible amount, based on what the government changed for January 1. My premiums and deductibles will be unique to me and my fellow August renewals, which would be different than the schedules for my “November” neighbor. Difficult to track? Well, we’re in a computer age that should handle that variation, and people will soon know what pertains to them in particular.
Some medical billings come months after the fact, and actual payment made in a different tax year than when the service was received. The IRS will look at when paid, not when incurred. So we’re already used to non-calendar year situations when doing our taxes.
I think I may be 30 years ahead of my time.

Posted by: Jennifer | Oct 25, 2013 8:21:46 AM

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