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Medicare News
Senior Citizens Should Review Medicare Health Plan
Options for Changes in 2008
Most private health plans in Medicare change costs,
benefits year-to-year
 Oct. 2, 2007 – Everyone enrolled in a Medicare
private health plan should review their health coverage options for next
year, since most private plans will change their costs and benefits,
according to the Medicare Rights Center (MRC).
People have the right to change Medicare health
plans for 2008 from Nov. 15 through Dec. 31. Most people can also change
their health plans once, between January 1 and March 31; they are then
locked into their health plan for the rest of the year.
“No one in a Medicare private health plan is free
from the complex task of having to review all of the plan options all
over again for 2008,” said Robert M. Hayes, president of the MRC, a
national consumer group.
“A private Medicare health plan that worked well
for someone this year could be much more costly and offer different
health benefits next year.”
Americans with Medicare can choose to receive their
health benefits through Original Medicare, the public program that
allows you to see virtually any doctor anywhere in the country. Four out
of five people with Medicare keep Original Medicare.
Medicare private health plans, another option, are
available through private insurance companies, and are generally managed
care plans where rules and restrictions apply.
Many offer Part D drug coverage as part of their
benefits package. Medicare health plan choices vary by county but
usually include health maintenance organizations (HMOs), preferred
provider organizations (PPOs), and private fee-for-service plans (PFFS).
Some things to consider when deciding whether to
join a Medicare private health plan are:
● Will I be able to use my doctors?
● Which specialists, hospitals, home health
agencies and skilled nursing facilities are in the plan's network?
● Do I have to pay a plan premium?
● How much will it cost to see my primary care
physician? A specialist?
● How much will I pay for a hospital stay?
● What service area does the plan cover?
● What kind of coverage will I have if I am
traveling outside of the service area?
● Are my prescription drugs on the health plan's
formulary (list of covered drugs)?
Other things you should know when choosing a health
plan are:
● If you choose Original Medicare, it is
advisable to purchase a “Medigap” plan to lower your out-of-pocket
costs, unless you have supplemental coverage from a current job, a
spouse’s job or retiree health coverage.
● If you have retiree health coverage, be sure to
find out if it works with a Medicare private health plan. If you join a
private health plan you may lose your retiree health benefits and never
get them back.
● People enrolled in Medicare private health
plans must generally get their drug coverage through the private plan.
● People with Original Medicare can get drug
coverage through a “stand-alone” Medicare private drug plan, or if they
have it, from a current job, a spouse’s job or retiree health coverage.
People with Medicare need to be on guard against
private health plan marketing abuse and fraud. Unscrupulous sales agents
have been known to take advantage of people’s confusion and enroll them
in health plans they never intended to join.
“‘Read the fine print’ is easier said than done
when one is facing stacks of glossy brochures or listening to a sales
pitch,” said Hayes. “Our free resources will guide you through the
decision-making process step by step in consumer-friendly language.”
The Medicare Rights Center offers the following
resources, at no charge, to help people make a health plan choice that
best meets their needs:
Medicare Interactive:
www.medicarerights.org/help.html
MRC’s free, web-based counseling tool provides
consumer-friendly information about Medicare benefits, rights and
options, including:
● state-specific health care information
● a chart on how to compare your Medicare health
plan options
● explanations of the different types of Medicare
private health plans
● questions to ask before joining a Medicare
private health plan
● tips on how to avoid marketing fraud
Telephone Counseling
Consumers who prefer to speak with a counselor can
call the Medicare Rights Center’s toll-free hotline at 1-800-333-4114.
Counselors are available Monday through Friday, 9AM – 1PM (Eastern
Time).
Medicare Rights Center claims to be the largest
independent source of health care information and assistance in the
United States for people with Medicare (www.medicarerights.org).
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