"There are a lot of little tricks that get done to offset the difference in reimbursement," said All

Medicare health and drug plans change somewhat each year, but analysts say seniors may see more changes this time, in part because of health-care reform. Fewer prescription-drug plans, homes for sale los angeles a new "doughnut hole" drug-discount provision and higher costs for some Medicare Advantage plans could affect the often-confusing selection process.
Enrollment for Medicare continues through Dec. 31. Most people now enrolled in Medicare will be locked into their existing health and drug plans unless they select a new option, but consultants say seniors should at least review homes for sale los angeles their plans to check whether they still provide homes for sale los angeles the type of coverage that they need.
"People need to look at their plan and compare it to options that are out there today," said Margaret Nowak, a director of Washington, D.C.-based Avalere Health. "Compare not only premiums, but whether the plan has a deductible. Does it cover the medications that you take every day?"
The two main types of health coverage are original Medicare directly from the government and Medicare Advantage, which comprises Medicare insurance plans that are administered by private insurance companies such as Humana or Cigna.
About three out of four people nationwide select original Medicare. Federal health reform requires all insurance plans - including original Medicare - to offer consumers free wellness exams and age-appropriate preventative checks such as mammograms and colonoscopies.
Original Medicare does not include prescription-drug coverage. Seniors are encouraged to purchase stand-alone prescription-drug plans that cover drugs, also known as Part D plans, with premiums that start at $14.80 each month.
The agency that oversees Medicare has encouraged consolidation of prescription-drug plans. One result is there will be 30 prescription-drug plans offered in Arizona next year, down from 46 such plans available to consumers this year.
Avalere offered one example of how the drug-plan changes will impact monthly price. homes for sale los angeles UnitedHealthcare is folding its AARP Saver plan into a more robust plan, called the AARP Preferred plan. Existing Saver customers will see their monthly premiums increase $4.58 when they switch to the Preferred plan in 2011. However, existing Preferred customers will see average monthly premiums decrease by more than $4 in 2011.
Still, people must evaluate other factors such as co-payments homes for sale los angeles and whether plans will cover the prescription drugs that they use the most. Medicare's website has a tool that allows consumers to check and compare plans.
One health-reform benefit passed along to seniors in 2011 will be a prescription-drug discount for those who have reached homes for sale los angeles a coverage gap known as the "doughnut hole." Drug manufacturers have agreed to provide a 50 percent discount on brand-name drugs and a small discount on generics.
Brokers and consultants say the bigger changes may be among private insurance companies homes for sale los angeles that offer Medicare plans, known as Medicare Advantage. Some of these plans may cover only health insurance, while others cover both health insurance homes for sale los angeles and prescription-drug coverage.
Historically, these insurance plans have cost less up front than original Medicare. But they also may include standard restrictions offered by traditional private health-insurance plans, such as limiting "in-network" rates to certain homes for sale los angeles doctors or hospitals or capping benefits.
Brokers say that some Medicare Advantage plans are beginning to charge higher monthly premiums and fees to customers. These increased costs may be the result of plans' anticipation of lower reimbursement from the federal homes for sale los angeles government homes for sale los angeles as health reform sets new guidelines.
"There are a lot of little tricks that get done to offset the difference in reimbursement," said Allan Zee, a health insurance broker with Scottsdale-based Argeus Benefits Group. "It is too early to tell how steep (increases) will be and what is going to get cut."
The federal health law will reduce payments to Medicare Advantage plans over time, with most provisions phased in between 2012 and 2014. By then, federal law will require insurers to spend at least 85 percent of premiums on health care.
This month, the centers suspended enrollment for three Medicare Advantage plans: Health homes for sale los angeles Net, Universal American, and Arcadian Management Services. The federal government action prevents the plans from enrolling new customers but does not affect existing homes for sale los angeles customers.
Health Net, which ranked No. 2 in size among Arizona Medicare Advantage plans based on enrollees as of 2009, said in a statement that the company is working with the federal agency to resolve any concerns. The centers' homes for sale los angeles suspension of Health Net stemmed from an audit of the health insurer's plan. A Health Net spokeswoman said the marketing suspension was not a reflection of the company's financial health.
homes for sale los angeles Ritch Steven, a retired health-care executive and AARP volunteer, talks with Arizona seniors about changes to Medicare Advantage plans. He said that when he explains the facts about the changes most people are no longer fearful.
One change that Medicare enrollees are discovering is that the time frame for enrollment is stricter. Medicare previously allowed people to change plans during the first few months of the year. Now, those eligible to enroll will be required to select a plan by the end of December.
"Medicare selection is very confusing, and it can be very intimidating homes for sale los angeles even for the most sophisticated individuals," said Paul Gada, a financial planning director for Belleville, Ill.-based Allsup. "We're doing what we can to help people deal with the shortened enrollment window."
Medicare has two parts, Part A (hospital homes for sale los angeles insurance) and Part B (medical insurance). You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years.
Medicare's website, www.medicare.gov , has information and tools about insurance plans and drug plans available to consumers. Under the website's "health and drug plans" tab, you can access a tool to compare coverage options and out-of-pocket costs.