The New 2013 Anthem Medicare Preferred Standard PPO from Anthem Blue Cross has been released! This Medicare Advantage Plan in California known as Anthem Medicare Preferred Standard was introduced to the market last year as a Local PPO. It gained membership quickly and it remains as one of the best Medicare Advantage PPO plans in the state. This Medicare Advantage Plan with Part D (also known as MAPD) offers significant freedom of choice with your medical service providers, however it is only available in certain counties throughout California and the benefits differ from one county to the next.
Anthem’s New 2013 Preferred Standard LPPO Medicare Advantage Plans for California Counties
For those members in California with Anthem Blue Cross’s Preferred Standard PPO may find they are facing re-enrollment for New 2013 Preferred Standard LPPO. Anthem has made changes to the premiums and out of pocket maximums in some counties forcing members to re enroll for the same plan. As of today we know San Diego and Ventura county members will be affected and we will keep updating this post as information is available to us.
The Preferred Standard LPPO Plan will have the same name and many of the same quality benefits, but in affected counties members will be forced to re enroll or choose another plan or carrier. SEP (Special Election Period) will rules apply that give poeple longer to make a choice.
Need help or have a question? Call our Toll free number to be connected with a qualified medicare specialist.
Check back for updates.
The Medicare Open Enrollment Period for 2013 is coming up soon! For a quick rundown on what you need to know, take a look at this basic Q&A.
1. What is it?
Throughout the year, Medicare has different enrollment periods. The Open Enrollment Period, or OEP, is the timeframe during which Medicare beneficiaries (people with Medicare) can make changes to their Medicare plans.
What’s in a name? In past years, you may have heard the Open Enrollment Period referred to as the “Annual Enrollment Period,” or even the “Annual Election Period.” Both of those (and the acronym that went with them, “AEP”) are older names for what officials at the Centers for Medicare & Medicaid Services are now calling Open Enrollment Period.
2. When is it?
OEP comes in the fall. As in 2011, this year’s OEP will take place October 15 through December 7, 2012. Any changes you make to your Medicare plan during this period go into effect on January 1, 2013.
3. What changes can you make?
During OEP, you can…
- Switch from Original Medicare (Medicare Parts A and B) to a Medicare Advantage (Medicare Part C) plan.
- Switch from a Medicare Advantage plan back to Original Medicare.
- Switch from one Medicare Advantage plan to another. This might involve switching from a plan without Medicare Part D prescription drug coverage to one that has it, or vice-versa.
- Make changes to your Medicare Part D prescription drug plan:
- Join a Part D plan.
- Switch from one Part D plan to another one.
- Drop your Part D plan altogether.
Note: Medicare Supplement Insurance plans are an exception. You can join one at any time during the year, not just during OEP.
4. Why is OEP so important?
Once the Medicare Open Enrollment Period closes on December 7, you can’t make any changes to your Medicare plan until the following year. There are some exceptions, such as if you move out of the area served by your plan. But for most people on Medicare, the OEP is the only time when you can make a change.
5. Do you have to make a change during OEP?
Absolutely not! If the Medicare coverage you have now is working for you, and your plan(s) is offered for 2013, then you can keep your coverage as it is. However, because this time comes but once a year, it’s a good idea to evaluate your coverage during Open Enrollment Period every year. That way, you’ll know if you already have the best coverage options for you, or if you need to make some changes.
6. How can I get ready for OEP?
Medicare Made Clear has you covered! We’ve got two series aimed at OEP preparation scheduled for the Medicare Made Clear blog:
- The first series is called Countdown: Medicare Open Enrollment Period 2013, and will run throughout September 2012. This series will help get you thinking about some of the bigger issues and questions connected with your Medicare coverage for 2013.
- The second blog series is called Open Enrollment Period 2013 Boot Camp, and will run in October and November 2012. It’ll offer very specific exercises to go through to help you evaluate your current 2012 Medicare coverage. That will help you know what decisions to make during OEP for 2013.
For more information, contact the Medicare helpline 24 hours a day, seven days a week at 1-800-MEDICARE (1-800-633-4227), TTY 1-877-486-2048. If you have questions about Medicare Made Clear, call 1-877-619-5582, TTY 711, 8 a.m. – 8 p.m. local time, seven days a week.
Timing Matters: Medicare Eligibility and Enrollment Windows – MedicareMadeClear.com
Understanding Medicare Enrollment Periods – Medicare.gov
WASHINGTON — The GOP-led House approved a 2013 budget Thursday that would cut taxes for the wealthy, revamp Medicare and slash federal spending.
Thursday’s 228-191 vote, mostly along party lines, will fuel the debate playing out in Congress and on the campaign trail.
Republican presidential candidate Mitt Romney has embraced the GOP proposal, which is at odds with President Obama’s blueprint that includes higher taxes on the wealthy and corporations.
It is the GOP’s proposed overhaul of Medicare, the federal health program for the elderly and disabled, that could provide the greatest contrast between the parties.
Republicans want to create a new system under which future retirees would get a stipend to buy health insurance, an approach the GOP says would hold down costs and begin to rein in the deficit.
Democrats argue that, under the GOP plan, the rising costs of health care will be shifted to seniors, who will end up paying more. No Democrats voted for the bill, and the Obama administration attacked it.
“House Republicans today banded together to shower millionaires and billionaires with a massive tax cut paid for by ending Medicare as we know it,” said White House spokesman Jay Carney.
Neither the House Republican budget nor the one from the White House will be approved by the politically divided Congress,both represent campaign manifestos.
The GOP budget would slash federal spending, including for college Pell grants, food stamps and Medicaid for the poor and disabled, and would shift required Pentagon cuts brokered with the debt deal to nondefense accounts.
Analysts say the wealthiest would benefit disproportionately from the proposed tax cuts, which would cap individual and corporate tax rates at 25 percent, down from today’s 35 percent brackets.
Republicans say tax cuts lead to investment and job growth.
Material from The Associated Press is included in this report.
The annual open enrollment window that allows people to make changes to their Medicare Advantage health insurance and Part D prescription drug coverage will close Wednesday, a couple of weeks earlier than in previous years.
Many beneficiaries have until midnight, Dec. 7 to decide whether to switch from one Medicare Advantage plan to another. The midnight deadline is based on where the beneficiary lives and does not reflect one time zone, a spokesman for the Centers for Medicare and Medicaid Service said.
Medicare Advantage plans are privately run versions of the government’s Medicare program, which provides health coverage for the elderly and disabled people. They offer basic Medicare coverage topped with extras, such as vision or dental coverage or premiums lower than standard Medicare rates.
Medicare Advantage open enrollment normally ends Dec. 31, but the health care overhaul calls for the earlier deadline to ensure that new coverage begins as planned on Jan. 1. The new date provides more time for applications to be processed by the end of the year.
Options do not completely dry up if a beneficiary misses the Dec. 7 deadline. From Jan. 1 to Feb. 14, Medicare Advantage customers can drop their plans and enroll in regular Medicare. During this time, they also can pick a Part D prescription drug plan to go along with that coverage, but they cannot jump to another Medicare Advantage plan.
Beneficiaries also can enroll any time during the year in a Medicare Advantage plan that has prescription drug coverage if they receive a low-income subsidy or if they have access to a plan with a five-star quality rating.
Medicare Advantage plans cover more than 11 million people. UnitedHealth Group Inc. and Humana Inc. are the largest Medicare Advantage plan providers in terms of enrollment, but many other insurers also provide the coverage.
Thursday, October 20, 2011
Anthem, SCAN To Cease MA Plan Coverage for 140,000 Beneficiaries
More than 140,000 elderly California residents will have to find new Medicare Advantage plans, according to industry and government officials, Payers & Providers reports.
Anthem Blue Cross of California and SCAN Health Plan are terminating coverage under certain plans because of government mandates and business reasons.Chang
es for Anthem Policyholders
Anthem has decided to shut down its MA Freedom Blue plan, which offered coverage through a PPO. The move affects about 110,500 beneficiaries.Darrel Ng, a spokesperson for Anthem, said the “decision to discontinue the plan was made after evaluating the changes to the benefits, the pricing and the regulatory approval needed to make this plan financially viable in 2012 and beyond.”
Ng added that beneficiaries can enroll in other Anthem MA plans and that their enrollment period has been extended to Feb. 28, 2012.
Changes for SCAN Policyholders
SCAN must drop about 30,000 policyholders from its Healthy at Home plan because of a change in Medicare regulations.
The plan covered individuals who have chronic conditions. As a non-exclusive plan, it could enroll people who did not have special needs as long as the total number did not exceed certain percentages.However, the Medicare Improvements for Patients and Providers Act of 2008 barred non-exclusive plans beginning in January 2012.Sherry Stanislaw, a SCAN spokesperson, said that affected policyholders could enroll in another SCAN plan, another MA plan or choose fee-for-service coverage.
Affected beneficiaries also have until the end of February to select another plan (Payers & Providers, 10/20).
Nine Medicare Advantage Plans Receive Five-Star Ratings in 2012, CMS Data Show
Nine Medicare Advantage plans received top quality ratings for 2012 from the Centers for Medicare & Medicaid Services, three times as many as in 2011, according to data released Oct. 12 on the agency’s website.
The rankings, based on care and service quality measures across five categories, are made at the specific plan or contract level.
The MA plans that received an “overall” score of five stars for “excellent performance,” which includes both the plans’ Part D drug rating and Part C health care rating, are:
• Baystate Health Inc.’s Health New England, Massachusetts;
• Group Health Cooperative, Washington state;
• Gundersen Lutheran Health System Inc., Wisconsin;
• Marshfield Clinic’s Advocare, Wisconsin;
• Martin’s Point Health Care Inc.’s Generations Advantage, Maine; and
• four Kaiser Foundation Health Plans, marketed as Kaiser Permanente Senior Advantage, and available in California, Hawaii, Colorado, and Oregon/Washington.
Jonathan Blum, CMS’s deputy administrator and director of its Center for Medicare, told an industry conference in September that there would be a few more top-rated plans in 2012 than the three five-star plans in 2011 (see previous article).
The three plans with top ratings in 2011 were the Marshfield plan and the Kaiser plan in Colorado, as well as Capital Health Plan, part of Blue Cross Blue Shield of Florida.
Wide Range in Size
The nine in 2012, all health maintenance organizations, have a wide range of enrollment—from 797,669 for the Kaiser plan in California to 5,349 for Baystate Health.
“The Medicare star quality rating system encourages health plans to improve care and service, leading to better patient experiences across the board,” Jed Weissberg, a senior vice president at Kaiser Permanente, said in an Oct. 12 statement about his company’s four plans.
“Our organization maintains an ongoing commitment to quality that is shared by our physicians and employees who provide care and service to our members each day,” Weissberg added.
Larry Henry, a vice president at Martin’s Point, said in a statement that “the advantages our plans will receive as a result of the five-star rating will help us continue to improve our ability to provide our members with industry leading quality and serve as a competitive advantage moving forward.”
The five-star rating provides bonus funds and additional marketing privileges to the highest rated plans.
Five-star plans receive payment bonuses of up to 5 percent additional reimbursement and 10 percent in certain “double bonus” counties.
The 2012 plan quality results will be used for 2013 reimbursement.
The five-star plans also receive “high performer” or “gold star” icons in their listings on Medicare’s Plan Finder and are allowed to market to beneficiaries during the entire year. Medicare beneficiaries may switch to an available five-star plan at any time.
For other plans, the Medicare open enrollment period, in which beneficiaries are allowed to enroll in plans, begins on Oct. 15 and lasts seven weeks to Dec. 7.
Barclays Capital Equity Research said in research released Oct. 12 that the overall MA rating for 2012 was 3.56 stars, up 0.11 star over the last year.
CMS’s performance data files are available at http://www.cms.gov/PrescriptionDrugCovGenIn/06_PerformanceData.asp.
Pay Less and Get More with Blue Cross of California Medicare Advantage Plans
Did you know that approximately 5.9 million Americans are currently receiving hospital, medical, and prescription drug coverage in one simple Medicare plan? You can join them. All you have to do is sign up for a Medicare Advantage Plan, or MAPD. Blue Cross of California offers three MAPD plans to qualifying seniors. Each of these plans offers lower out-of-pocket costs than the standard Medicare Plan. In addition, you’ll receive many benefits that are not included in basic Medicare, such as prescription drug coverage, physical exams, vision services, and hearing services. To learn more about our MAPD plans, click on the links below.
Anthem Blue Cross is discontinuing their Regional Freedom Blue PPO Health Plans for all of California
Anthem Blue Cross is discontinuing their Regional Freedom Blue PPO health plans for all of California including renewals for 2012. The information is that Anthem wants to protect their financial stability into the future by trimming cost. Please contact a MedicareAdvantageCalifornia Representative to validate this information. In addition, we have information they will no longer offer the Anthem Blue Cross Senior Secure Plan (HMO) in Santa Barbara County. If you have the Freedom Blue Plan and wish to change to the Anthem Medicare Preferred Standard (PPO) please call 800-260-9051 or visit http://medicareadvantagecalifornia.com/anthem_medicare_advantage_plans.html for information and assistance. Anthem is also allowing current Freedom Blue members to join Anthem Blue Cross Supplement Plans with guaranteed issue and extended enrollment period. Call for more information today.
CMS Unveils Quality Ratings for Medicare Advantage Plans
On Wednesday, CMS released its 2012 Medicare Star Quality Ratings, which rates Medicare Advantage plans based on 36 measures. Kaiser Permanente operates four of the nine MA plans that received five-star ratings. Top-scoring plans can enroll new members at any time, instead of just during the open enrollment period, which runs from Oct. 15 to Dec. 7. Meanwhile, a recent Kaiser Permanente survey found that just 18% of Medicare beneficiaries are aware of the star ratings and just 2% know their current plan’s rating.