fwd: HMO's to stiff elderly

ROSAPHILIA (rugosa@interport.net)
Thu, 25 Dec 1997 02:58:38 +0000


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> >From Families USA--
> Some HMOs Set to Cut Elderly's Benefits
>
> 12/22/97 - Some senior citizens who use HMOs will begin to see perks
> like prescription drugs cut back after the first of the year as the health
> plans react to higher enrollment and Medicare changes in the balanced
> budget deal, reports Associated Press.
>
> ``We believe this is the beginning of the end of zero-premium plans and
> additional freebies for seniors in Medicare HMOs,'' said Diane Archer,
> executive director of the Medicare Rights Center. ``Seniors
> should...understand that their free prescription drugs, eye glasses and
> hearing aids may very soon disappear.''
>
> Medicare HMOs accept a fixed monthly payment from the government for
> each person covered, no matter how much medical attention they need.
> The plans generally limit choice of doctors and closely control access to
> specialists. But in many parts of the country they have been able to offer
> low- or zero-premium coverage and even services, such as prescription
> drugs, not normally paid for by Medicare.
>
> But as about a 100,000 seniors a month rush to join HMOs the health
> plans are finding it harder to keep offering the perks. More than 16
> percent of the 38 million Medicare beneficiaries now belong to HMOs.
> The rolls are including increasing numbers of older and sicker people
> who need more expensive care.
>
> Adding to the strain, Congress and President Clinton, as part of the
> balanced budget deal, agreed to curtail yearly payment increases to
> HMOs, in hopes of saving Medicare from bankruptcy for another decade.
> As a result, some HMOs accustomed to as much as 9 percent yearly
> raises from the government will get only 2 percent next year.
>
> ``It is not surprising to see some benefit changes created by the new
> payment levels,'' said Don White, spokesman for the American
> Association of Health Plans. ``However, it is very important to remember
> that (HMOs) serving Medicare beneficiaries will continue to offer more
> benefits for lower out-of-pocket costs than are available in the
> traditional
> Medicare system.''
>
> In Pennsylvania, Keystone Health Plan Central will increase 1998 monthly
> premiums by as much as $35 and eliminate prescription drug coverage
> for some of the eight counties and 21,000 Medicare beneficiaries the
> company serves.
>
> ``Costs have exceeded the reimbursement coming in from the
> government,'' said Bill Wolfe, a vice president of Keystone, which is
> jointly owned by Capital Blue Cross and Pennsylvania Blue Shield.
>
> Other plans are increasing patient co-payments for perks that were once
> free, or charging premiums where they hadn't before.
>
> Bruce M. Fried, director of Medicare's Center for Health Plans and
> Providers, confirmed that more plans nationally are making such changes
> for 1998. But Fried said that HMOs will continue to be ``very
> economically attractive'' for most beneficiaries.
>
>
> This article is taken from the News & Blues forum on HandsNet. To learn
> more about HandsNet, check out their web site at:
>
>
> www.handsnet.org/handsnet
> Patrice Franklin, Deputy Field Director
> Families USA
> 1334 G Street N.W.
> Washington, DC 20005
> 202-628-3030
>
> pfranklin@familiesusa.org
>
> Web Site: http://www.familiesusa.org
>


--
GABRIELLI WINERY  of Redwood Valley, Mendocino, California:
    SANGIOVESE * PINOT NOIR * ZINFANDEL RESERVE
   ASCENZA (white blend) * RIESLING * CHARDONNAY
   http://www.interport.net/~rugosa/gabriell.html
          Better Living Thru Better Living


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>From Families USA--
Some HMOs Set to Cut Elderly's Benefits

12/22/97 - Some senior citizens who use HMOs will begin to see perks
like prescription drugs cut back after the first of the year as the health
plans react to higher enrollment and Medicare changes in the balanced
budget deal, reports Associated Press.
 
``We believe this is the beginning of the end of zero-premium plans and
additional freebies for seniors in Medicare HMOs,'' said Diane Archer,
executive director of the Medicare Rights Center. ``Seniors
should...understand that their free prescription drugs, eye glasses and
hearing aids may very soon disappear.''
 
Medicare HMOs accept a fixed monthly payment from the government for
each person covered, no matter how much medical attention they need.
The plans generally limit choice of doctors and closely control access to
specialists. But in many parts of the country they have been able to offer
low- or zero-premium coverage and even services, such as prescription
drugs, not normally paid for by Medicare.
 
But as about a 100,000 seniors a month rush to join HMOs the health
plans are finding it harder to keep offering the perks. More than 16
percent of the 38 million Medicare beneficiaries now belong to HMOs.
The rolls are including increasing numbers of older and sicker people
who need more expensive care.
 
Adding to the strain, Congress and President Clinton, as part of the
balanced budget deal, agreed to curtail yearly payment increases to
HMOs, in hopes of saving Medicare from bankruptcy for another decade.
As a result, some HMOs accustomed to as much as 9 percent yearly
raises from the government will get only 2 percent next year.
 
``It is not surprising to see some benefit changes created by the new
payment levels,'' said Don White, spokesman for the American
Association of Health Plans. ``However, it is very important to remember
that (HMOs) serving Medicare beneficiaries will continue to offer more
benefits for lower out-of-pocket costs than are available in the
traditional
Medicare system.''
 
In Pennsylvania, Keystone Health Plan Central will increase 1998 monthly
premiums by as much as $35 and eliminate prescription drug coverage
for some of the eight counties and 21,000 Medicare beneficiaries the
company serves.
 
``Costs have exceeded the reimbursement coming in from the
government,'' said Bill Wolfe, a vice president of Keystone, which is
jointly owned by Capital Blue Cross and Pennsylvania Blue Shield.
 
Other plans are increasing patient co-payments for perks that were once
free, or charging premiums where they hadn't before.
 
Bruce M. Fried, director of Medicare's Center for Health Plans and
Providers, confirmed that more plans nationally are making such changes
for 1998. But Fried said that HMOs will continue to be ``very
economically attractive'' for most beneficiaries.


This article is taken from the News & Blues forum on HandsNet. To learn
more about HandsNet, check out their web site at:


www.handsnet.org/handsnet
Patrice Franklin, Deputy Field Director
Families USA
1334 G Street N.W.
Washington, DC 20005
202-628-3030

pfranklin@familiesusa.org

Web Site: http://www.familiesusa.org
 

--
GABRIELLI WINERY  of Redwood Valley, Mendocino, California:
    SANGIOVESE * PINOT NOIR * ZINFANDEL RESERVE
   ASCENZA (white blend) * RIESLING * CHARDONNAY
   http://www.interport.net/~rugosa/gabriell.html
          Better Living Thru Better Living
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