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Medicare HMOs to cut back benefits
By KRIS HUNDLEY
© St. Petersburg Times, Medicare HMOs have released details of their 2002 benefit plans to the federal government and will be sending a letter to beneficiaries in the next two weeks. Bottom line: More money will be coming out of seniors' pockets for health care. HMO benefits -- particularly drug and hospital coverage -- will be pared back, dramatically in some plans. Fortunately for Medicare beneficiaries in the Tampa Bay area, however, there are still several zero-premium options available. After the latest round of plan withdrawals, announced in letters to HMO members this week, there will be at least three plans left in each of Hillsborough, Pinellas, Pasco and Hernando counties. Citrus County does not have a Medicare HMO. Medicare beneficiaries who opt for an HMO must select a plan for 2002 starting in November. While people have been able to switch HMOs on a monthly basis in the past, next year Medicare HMO members will be able to make only one change through June, then they'll be locked in that plan for the rest of the year. Though no-cost Medicare HMOs will still be available locally, the hitch is that none of the plans include coverage of brand drugs, usually a big expense for Medicare recipients. The only plan that will pick up part of the cost of brand-name prescriptions is BlueCross BlueShield of Florida. The trade-off is that the Blues plan charges a $70 per month premium, up from $63 currently. And its Medicare HMO is only available to a limited number of residents in mid-Pinellas County. Capacity of the Blues plan is about 9,000 members and priority will be given to existing members who wish to re-enroll. The remaining plans, sponsored by Humana, United Healthcare of Florida and Well Care, differ primarily in the details. United offers no assistance with prescriptions, even generic drugs. And a United member who is hospitalized has a daily co-pay of $375 per day. Other insurers limit a member's hospital co-pay to a certain amount per day for the first five days; after that, the insurer picks up all hospital costs. Ken Levey, a 66-year-old Safety Harbor resident, has a dual challenge. He's been on Humana's Medicare HMO while his wife, Marion, who takes more prescription drugs, opted last year for United's coverage. With United canceling any prescription coverage next year, Levey will be considering other alternatives. "I'll get on my calculator and start figuring how we'll get by," said Levey, who said his wife's prescriptions total about $200 per month. "And if I can't find a zero-premium plan, I'll go back to regular Medicare and pay what I have to pay." Details of all Medicare HMO plans for 2002 are on the Medicare web site (www.medicare.gov). People can also get help by calling Medicare at 1-800-633-4227 or Florida Elder Helpline at 1-800-963-5337. - Kris Hundley can be reached at hundley@sptimes.com or (727) 892-2996.
 © 2006 • All Rights Reserved • St. Petersburg Times
490 First Avenue South • St. Petersburg, FL 33701 • 727-893-8111 
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From the Times Business report
From the AP
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