Medicare Open Enrollment - The Next Casualty in the Battle For Insurance Equality

As the New York Times reported earlier this month, employees who are still fortunate enough to have group health insurance coverage from their employer (even though their plan options are shrinking along with the U.S. workforce), Medicare recipients will have the opposite problem in a few weeks- a potentially overwhelming and confusing list of choices. They may need to sort through dozens -- even hundreds -- of plans governing everything from diabetic supplies and home medical devices to prescription drugs and physical exams during the annual enrollment period, which starts on November 15.

Happy New Year!...Now Open Your Wallet.

The Medicare open enrollment process is fast becoming another casualty in the battle for healthcare equality in America. But there's still money to be made in the midst of confusion and healthcare entrepreneurs know it. It's the reason why television viewers are barraged daily by folksy, personal pitches from trustworthy actor icons like Wilford Brimley and Tom Bosley who talk Seniors into Part B supplements and Part D prescription drug plans; push power chairs at "no cost to you"; and propagate no finger-prick diabetic meters in a jellybeanish array of colors. It's a product marketing machine with no signs of slowing down. "Companies are allowed to start marketing for the annual enrollment period on Oct. 1," says Seemin Pasha, director of policy and communication at Health Assistance Partnership, a consumer advocacy group. "But sifting through all these materials can be confusing."

It's hard not to imagine how the basics of "Medicare-speak" in America have caused otherwise healthy Seniors to buy into the falsehood that they're suddenly incapable of living their lives without products of paranoia. But for those Seniors who truly need the services that so-called "Medi-Gap" coverage (Part B) provides, this year's enrollment process will require a bitter pill to swallow.

All the Moving Parts

Medicare Part A covers hospitalizations and is provided at no charge to enrollees. Part B covers fees from doctors and other health care providers and requires a monthly premium. In years prior, both A & B were also rolled up into one and packaged as an Advantage plan with prescription drug coverage --- or Part D. This year, if you're under a packaged Medicare deal, you may soon lose your advantage. Or not. No one's really sure yet. Not even the government. But don't worry, seniors --- you'll get a little pamphlet or a letter soon to help you sort it out. Just make sure you have a magnifying glass when the mail man arrives.

Medi-Gap vs. Straight-Up Insurance

On the flip-side, obtaining a private health insurance quote for individuals has always been a pretty painless task. A click online here, a small questionnaire there, insert some personal info in a form and you're done. But if you're a Medicare recipient, paperwork rules the process. Plus, this year's open enrollment will add another layer of confusion to the already difficult Medicare bureaucracy, leaving Seniors to jump head-first into a bottomless pool of options for accessing our nation's public health care system. For starters, open enrollment will hit brand new Medicare enrollees hard.

A humble offering from Uncle Sam means no cost-of-living increase this year for Medicare Part B enrollees. Their rates will stay the same as for 2009, at $96.40 a month. However, if you're among the millions who are unemployed, are uninsured, or otherwise are on a fixed income and become a first-time Medicare recipient this year, you'll pay 15 percent more than established Medicare beneficiaries, at $110.50 a month. For a little more than that, Seniors can (and often do) buy individual private insurance coverage online for worry-free simplicity. No supplements, no packages and no bureaucracy.

Regardless of how the healthcare reform bill shakes out, competition is alive and well in the medical insurance marketplace. And so long as there are annual changes and premium hikes in Medicare, competition is here to stay. A former business journalist, current coffee fanatic and subject-matter expert in all-things-insurance, Michael lives in Miami.