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Friday, September 30, 2005

Mover Mike Warns Of Danger To Seniors

I had no idea about this - Mover Mike warns that some seniors who have HMO plans could be dropped from their plans if they sign up for the new drug benefit:
Before signing up for Medicare's new prescription drug plan, check with your current plan! You could end up with no health coverage, except for drugs.
I heard a public service announcement on the radio yesterday telling seniors to sign up. So pass the word. SacBee:
The potential for confusion is huge in California, which has the nation's highest enrollment of Medicare beneficiaries in managed care plans - 1.3 million people. Their coverage could be lost if they sign up for a drug plan offered by a different group.

Health plans want to get the word out to members that they could accidentally unenroll themselves by signing up for one of the 18 stand-alone prescription drug plans to be offered in California. A key point they want to emphasize: Those who are satisfied with their managed care plans don't have to do anything to get Medicare's new prescription drug coverage.

If, however, they sign up for a drug plan unconnected to their health plan, "it's going to bounce them out of their HMO," said Joan Parks, director of Sacramento's Health Insurance Counseling and Advocacy Program, also known as HICAP.
VA already provides better benefits, so if you are covered under VA you don't need to sign up. The Medicare HMO's are supposed to add the drug benefit, so you don't need to sign up at all if you have one of those. For more information try the FAQ at Medicare Rights Center.

I did find this information at Medicare Rights Center which seems to confirm what the SacBee article is saying:
If you are dissatisfied with your HMO, for any reason, you have the right to switch to another HMO or disenroll from the HMO and return to Original Medicare on a monthly basis throughout the year. (The lock-in requirement that was to take effect in 2002 has been postponed until 2006.)

To disenroll you can either:

* Sign up for a new HMO (you will be automatically disenrolled from your old HMO when your new HMO enrollment becomes effective);

* Write a letter to your HMO stating your intent to disenroll; or

* Fill out form 566 at your local Social Security Office.

You will be officially disenrolled on the first day of the month after you disenroll. Until you are officially disenrolled, you should continue using the Medicare HMO to obtain coverage for your health care.
How confusing. After roaming through the official Medicare site, I discovered that if you have a Medicare Advantage or Medicare Cost plan (which I believe are HMO umbrellas designations), then your plan is supposed to tell you in October what you will be getting from them in terms of drug coverage, so don't do anything until November (but you have to do it before January!).

One of the problems with accidentally disenrolling yourself is that you may be attending the wrong doctor to receive benefits under the new plan, I believe. Because different HMO's will be advertising and selling their own drug plans, it looks like if you are in an HMO plan and you sign up for another HMO's plan your coverage will automatically be switched.

I skim a lot of blogs, and so far yours is in the Top 3 of my list of favorites. I'm going to dive in and try my hand at it, so wish me luck.

It'll be in a totally different area than yours (mine is about danger of smoking) I know, it sounds strange, but it's like anything, once you learn more about it, it's pretty cool. It's mostly about danger of smoking related articles and subjects.
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