October 1996
DID YOU KNOW...
...ALL OVER THIS COUNTRY, PRESENTATIONS ARE GIVEN LURING SENIORS
TO MEDICARE HMOs?
Misrepresentations, unfortunately, are the rule as
agents try to convince seniors to buy into a Medicare HMO. Drawn by the prospect of paying
no monthly premiums, or very low ones, seniors are signing up for Medicare HMOS at an
unprecedented rate.
To seniors worried about their future health, it may
all sound too good to be true - and indeed it may be. (Between 1991 and 1992, the Humana
Health Plan of South Florida enrolled more than 123,000 new members. During that same
period, 64,000 dropped out.)
source: Physicians Who Care - Maxim #5
Medicare now pays HMOs more than enough to provide
the same benefits someone would receive outside the HMO. The Medicare business is so
lucrative for the HMOs, that it has become a major profit center for many plans. Medicare
may not continue their over generous payments indefinitely. If payments are reduced, HMOs
may charge seniors monthly premiums - perhaps substantial ones - and may even cut back on
the already limited benefits for eyeglasses, hearing aids and prescription drugs.
Some seniors may find themselves trapped in their
plan when they become unhapy and wish to return to traditional fee-for-service Medicare.
One may find it difficult or impossible to buy a new medigap policy.
Remember that in an HMO, you must go through a
primary care doctor who works for the HMO. You may not be referred to specialists when
necessary. Your choice of specialist, your course of treatment, etc. are dictated by the
primary care physician. You lose freedom of choice and the ability to make your own
decisions.
Think very carefully and research all of the plan's
coverage and limitations before jumping into what sounds, on the surface, to be a great
dea. Medicare is doing a good job of taking care of recipient's needs. We don't know how
the HMOs will handle your needs. Be an educated consumer. Remember, the HMO is in business
to make a profit. They will do all they can to save money so their profits will be
greater. Will this be at the expense of your health and welfare?
Medicare Changes Mailing Address
Policy
Many of our clients have requested that their
Medicare statements be sent directly to our office. However, Medicare is now enforcing new
guidelines as to where statements can be sent.
As of July 1, 1996, all Medicare statements will be
sent to the address that Social Security has on file. You can no longer have Medicare
statements mailed to one address, such as to a relative or person handling the paperwork,
and Social Security correspondence maild to another.
We have contacted HCFA, the Administrator for
Medicare, to voice our concern, however for now, please mail us all statements you receive
from Medicare - they will state "This is not a bill" at the top of the
Explanation of Benefits.
Welcome Back
For those of our clients returning to Florida from
the North we welcome you back. And as always, you are welcom to stop by and visit or call
to say Hello.
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