It's that time of the year again when all of my "Open Enrollment" materials arrive in the mail and I become so confused with all of the changes and how they will affect me.

I remember when I was employed as a Benefits Director for my company and we held meetings with all of our employees to explain the changes each November. They were always so concerned about increasing co-pays, higher deductibles, and increased contributions from their paychecks each week.

Well, now we have no employee meetings and I just need to muddle through the packet of materials from Medicare and AARP to see how I will be affected in 2011. To help you understand Medicare changes, here is a summary:

2010: The rest of this year:

  • Your guaranteed benefits from Medicare will not change for the rest of 2010; whether you are in an Original Medicare or Medicare Advantage Plan.
  • There will be changes in eligibility for Medicare.
  • You can still choose between Original Medicare, Medicare Advantage, and a Part D plan during the Annual Open Enrollment Period beginning November 15.
  • If you reach the "donut hole" in your Part D Prescription Drug coverage, you will receive a one-time, $250 rebate check if you are not already in Medicare Extra Help.

2011: Next year:

  • Medicare Advantage Plans: these are not going away. There may be some changes to premiums and benefits, but most Medicare members will have a choice of HMOs, PPOs, and Special Needs Plans.
  • All Medicare Advantage Plans will have an annual out-of-pocket maximum. The amount may vary by plan, but the out-of-pocket maximum in 2011 is $6,700.
  • As with Original Medicare, Medicare Advantage plans will continue to offer yearly wellness visits, screenings, and many preventive services at no extra cost beyond the Part B premium.


  • The Medicare Part D coverage gap will shrink over time, so you won't have to pay as much out of pocket for prescription drugs if you are in the gap.
  • In 2011, if you reach the coverage gap, you will never pay more that 93% of the cost of generic drugs or about 50% of the cost of most brand-name drugs while in the gap.

Be sure to read your notice of change and pay attention to your open enrollment period. For most people, November 15-December 31 is the only time to join or switch Medicare plans (Medicare Advantage or Part D plans). Enrollment closes on January 1, 2011!!

Related Posts:

Understanding Medicare RX Plans

Understanding Medigap Plans

How to Save Money on Your Health Insurance Part 2

Linda Reese

Linda is a contributing writer for the Retired & Loving it blog. Linda is retired, married, and enjoying her retirement in a retirement community in Florida. She shares her experiences with others who are facing retirement or already there with posts on living on a fixed income, budgeting, and healthcare issues. Compensated CareOne Blogger.

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