At Web of Care we understand that, as a caregiver, you probably have justifiable concerns about your health coverage. If you are currently enrolled in the Medicare+Choice program through an HMO, you may be in for a hassle: as of January 1, 2001, several HMOs will not offer the Medicare+Choice program.
HealthMetrix Research Inc. - a company that provides independent information on healthcare providers and other similar organizations - has compiled a briefing to assist Medicare HMO enrollees and their caregivers with making informed decisions related to these HMO withdrawals from the Medicare+Choice program.
Web of Care, with HealthMetrix's permission, has chosen to post this HMO briefing for the benefit of our members.
Up to 1 million Medicare beneficiaries enrolled in Medicare HMOs may be impacted by widespread HMO withdrawals from the Medicare+Choice program at the end of this year. While some beneficiaries will have options to join another Medicare HMO or a recently approved private fee-for-service (PFFS) insurance plan, others will have no choice but to return to traditional Medicare along with optional Medigap supplemental insurance. The withdrawals are expected to have the greatest impact on enrollees in rural and mid-sized markets where significant Medicare HMO withdrawals have occurred the past two years.
Timetable for Medicare+Choice Decisions
The timetable below indicates when events for the 2001 Medicare+Choice program are scheduled to occur and when Medicare beneficiaries are expected to make decisions about their coverage effective January 1, 2001.
Deadline for HMOs to file applications to participate in Medicare+Choice during 2001.
Week of July 10
Health Care Financing Administration (HCFA) to release the official list of HMOs withdrawing from Medicare+Choice effective January 1, 2001.
August - September
HCFA approves HMOs for Medicare+Choice contracts for 2001.
September 15 - October 15
HCFA mails the 2001 Medicare & You handbook to all Medicare beneficiaries.
Special sign-up period begins for HMO enrollees who choose to enroll in another Medicare HMO (if available) or apply for guaranteed issue (GI) Medigap policies A,B,C,F.
Deadline for renewing HMOs to provide notification letters to enrollees about benefit and program changes effective January 1, 2001.
Annual open enrollment period begins for the 2001 plan benefit year for all Medicare beneficiaries.
* Note: Many HMOs restrict "open enrollment" to November 1-30.
Effective date when coverage ends for enrollees in Medicare HMOs that withdraw from Medicare+Choice.
** Note: Beneficiaries who do not enroll in another Medicare HMO by this date will automatically be covered under traditional Medicare Part A and Part B. Beneficiaries may apply for guaranteed issue (GI) Medigap policies A,B,C,F through March 4, 2001.
September of after November 7th General Elections
Possible Congressional action to restore Medicare+Choice cutbacks enacted under the Balanced Budget Act of 1997.
Advice for Enrollees Impacted by Medicare HMO Withdrawals
Begin comparing other Medicare HMO plans today.
If provider choice is an important consideration, determine which hospitals, personal physicians and/or specialist physicians are included in other available Medicare HMO provider networks. Inquire about HMO member services and satisfaction from friends and relatives who may be enrolled in other Medicare HMO plans. Also, visit www.HMOs4seniors.com for independent Medicare HMO cost comparisons for over 50 cities based on current HMO plan benefits and beneficiary health status.
Request Medicare HMO marketing materials.
Materials can be requested on the Internet at www.HMOs4seniors.com or from individual plans by phone after September 15th when HMOs will have their new benefit and program changes available for 2001.
Circle October 1st on the calendar.
This is the earliest date that Medicare HMOs must accept new members from non-renewing Medicare HMOs. If intending to enroll in another Medicare HMO, plan to complete the application paperwork by December 10th in order to begin coverage under the new Medicare HMO plan by January 1, 2001. Compare available Medigap supplement insurance policies and premiums.
For Medicare HMO enrollees who will not have other Medicare HMO plans available, begin to compare the available Medigap supplement insurance policies (standard policies A-J except in Massachusetts and Wisconsin) and premiums that are offered. Policies A,B,C,F are available on a guaranteed issue (GI) basis between October 2 & December 4 and between January 1 & March 4. Explore a new Medicare+Choice option.
For residents of 17 states (AK, AR, ID, KY, LA, MN, MS, NE, NM, NV,
OH, OR, SD, TN, TX, UT, WV), a new Medicare+Choice private fee-for-service
(PFFS) insurance option is available from Sterling Life Insurance Company