Marci's Medicare Answers

October 2011

Dear Marci,

I just received a letter in the mail labeled Annual Notice of Change. What is this?

—Riley

Dear Riley,

The Annual Notice of Change, also known as the ANOC, is a notice your Medicare Advantage (MA) plan or Medicare Prescription Drug plan (PDP) sends you every year. The ANOC explains how your plan’s coverage and costs are changing for next year. Your plan must make sure you get your ANOC in the mail by September 30. It is very important that you read your ANOC and consider all of your options, since many plans make changes every year, and your current plan may not be your best choice for 2012. Your ANOC comes at the end of September so you can determine whether it is best to keep or change your plan for next year during the Fall Open Enrollment Period (October 15 to December 7).

When you review your ANOC from a PDP, pay particular attention the summary of the new formulary (list of covered drugs). The plan’s formulary may have changed for next year and new restrictions added. Be sure the new formulary still allows you to get the drugs you need. If you do not see one or more of your drugs on the summarized formulary, call your drug plan or check the plan’s website for their full list of covered drugs, and consider switching to another drug plan.

You should also review the ANOC for consolidations and terminations. Plans from the same company that offer nearly identical benefits continue to be consolidated to help simplify the choices available to consumers. If your plan is consolidated with other plan(s), you will automatically be enrolled in a plan from the same company that has benefits most like those you had. Even though you will automatically be enrolled in another plan, you have the right to choose and enroll in a different plan during the Fall Open Enrollment Period.

Terminated plans no longer participate in Medicare. If your plan has been terminated, you can use the Fall Open Enrollment Period to enroll in a new one, and you are also entitled to a Special Enrollment Period (SEP) to enroll in a new plan. The SEP lasts through February 29, 2012.

—Marci

Dear Marci,

Will Medicare cover counseling to help me quit smoking?

—Toni

Dear Toni,

Yes, Medicare covers counseling to help you quit smoking.

Medicare covers two counseling attempts at quitting smoking per year. Each attempt includes four sessions, which comes to eight sessions every 12 months. You can receive counseling at the clinic, outpatient department of a hospital, or doctor’s office (including offices of physicians, psychologists, and clinical social workers). A doctor or an approved Medicare provider must perform the counseling.

If you have Original Medicare, you no longer pay coinsurances or deductibles for smoking cessation counseling if you have not been diagnosed with an illness that is caused or complicated by smoking, and if you see a Medicare-recognized doctor or other health care provider. Medicare also covers smoking cessation counseling for those people with Medicare who have been diagnosed with a disease or condition caused or aggravated by smoking. In this case, Medicare will pay 80 percent of the approved amount for smoking cessation counseling, after you meet your Part B deductible.

If you are in a Medicare Advantage plan (private health plan), contact your plan to see what rules and costs apply. Starting in 2012, Medicare Advantage (MA) plans cannot charge you for preventive services that do not have cost-sharing under original Medicare.

—Marci

Dear Marci,

I heard the Fall Open Enrollment Period for Medicare Advantage and Private Drug plans changed. Is this true?

—Robin

Dear Robin,

Yes, the Fall Open Enrollment Period dates have changed. Starting this year, the Fall Open Enrollment Period begins on October 15 and lasts through December 7.

During Fall Open Enrollment, you have the right to change your Medicare health and drug coverage options without restriction. This includes:

• Changing your choice of health coverage;
• Adding, dropping or changing Medicare drug coverage.

You can make as many changes as you need, and the last change they make on or before December 7 will take effect on January 1 of next year. However, to avoid enrollment problems, it is best to make as few changes as possible.

—Marci

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Marci’s Medicare Answers is a service of the Medicare Rights Center (www.medicarerights.org), the nation’s largest independent source of information and assistance for people with Medicare. To subscribe to “Dear Marci,” MRC’s free educational e-newsletter, click here.

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