Senior Advocates Urge Caution as HMO Members Enroll in Medicare Rx Benefit Plans
California Medicare beneficiaries who currently are enrolled in managed care plans could accidentally unenroll themselves by signing up for one of the 18 stand-alone Medicare prescription drug benefit plans that take effect Jan. 1, 2006, health officials warn, the Sacramento Bee reports.
According to the Bee, the "potential for confusion is huge" because 1.3 million Medicare beneficiaries in California are enrolled in managed care plans -- the nation's highest rate.
Senior advocates are concerned that beneficiaries will enroll in stand-alone plans without first contacting their HMO. Some managed care companies view enrollment in another HMO's drug plan as a decision to leave the health plan, which could leave seniors without health care coverage.
Joan Parks, director of Sacramento's Health Insurance Counseling and Advocacy Program, urged beneficiaries to be cautious. "Those with a great need of ongoing medications, they need to be very careful. One month out of a plan could be extremely costly or detrimental to them."
Denise Hanson, director of Medicare and state programs for Kaiser Permanente, said seniors enrolled in HMOs "shouldn't do anything until they hear from their current plan." Hanson said Kaiser officials are in discussions with CMS to retroactively re-enroll those who accidentally lose their coverage.
CMS officials said they will act to safeguard HMO members if they begin to see a trend of seniors losing coverage (Weaver Teichert, Sacramento Bee, 9/29).