For 2011 the time of year when seniors do their annual Medicare shopping is moved up.  Previously the enrollment period was from Oct 15th through Dec 31st.  The end date is now Dec 7th.  Changes become effective Jan 1st.

Enrollment provides seniors an annual opportunity to amend their Medicare coverage by choosing one of two basic options.  Traditional, fee-for service Medicare (government-provided) is available with or without Part D prescription drug benefits.  Alternatively a private, all-in-one solution known as Medicare Advantage is available.

Seniors wishing to change their mind may do so from Jan 1st through Feb 14th.  During this time seniors who opted for an Advantage plan may switch back to traditional Medicare with or without opting for an add-on prescription drug plan.  Not allowed during this ‘disenrollment period’ is a switch between Advantage plans.

Choosing a Part D prescription drug plan depends mostly upon options for formularies and pharmacies.  Issues pertaining to formularies include, but are not limited to, covered drugs, cost, co-pays, deductibles, physician authorization and quantity limits.  When it comes to pharmacies it’s important to find those that work with Medicare Part D which may or may not include less expensive mail-order options.

Medicare Advantage plans are mostly managed care offerings such as HMOs and PPOs making close study of in-network vs. out-of-network benefits and costs extremely important.  Medicare provides a fixed payment to the plans to cover hospitalization (Part A) and insurance (Part B).  Beyond that the private option kicks in after deductibles and co-payments.  Note this year brings a change in that Advantage plans may not charge cost-sharing (co-insurance, deductibles and co-pays) for preventive services that do not have a similar cost-sharing feature under traditional Medicare.

Medicare is a complex, ever-changing program.  Detailed, current information is available at Medicare’s website and by calling 1-800-MEDICARE.