| January 2, 1998 |
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New Year Brings Medicare ChangeBy ALICE ANN LOVEAssociated Press Writer WASHINGTON (AP) From new preventative care benefits to more health plan choices, senior citizens this year will see the biggest changes to Medicare since the government health insurance program was founded more than three decades ago. "It's the biggest thing we've ever done," said Medicare administrator Nancy-Ann Min DeParle. Because of changes included in the balanced budget deal, nearly 40 million seniors and disabled people covered by Medicare today got new benefits for mammograms and colorectal cancer screenings. Also this year, beneficiaries will get information in the mail and on the Internet about new types of private health plans they can join starting in 1999. Medicare's traditional fee-for-service program, in which the government pays people's doctor bills directly, will remain an option. Starting today, Medicare will cover yearly mammograms to check for breast cancer in women over 40, even if they have not met their annual $100 deductible. Women also no longer have to pay a deductible before getting coverage for pap smears and pelvic exams once a year for those at high risk for disease and every third year for others. Colorectal cancer screenings are also covered for the first time for all Medicare beneficiaries over age 50. The monthly Medicare premium beneficiaries pay for coverage of doctors' office visits and other outpatient treatment remains at $43.80 for 1998. On July 1, more new preventative benefits will kick in. Women at high risk of developing the bone-weakening disease osteoporosis will be covered for bone-density tests. And new Medicare benefits will become available to an estimated 3 million people with diabetes, including coverage of glucose monitoring equipment and instruction in how to manage self-care. New coverage of annual prostate cancer screenings for men over 55 will start on Jan. 1, 2000. Early in 1998, Medicare plans to put a new database on the Internet that will help seniors get familiar with health plan choices that will increase dramatically over the next several years. Seniors who want to weigh their options will be able go on-line or visit a senior center or insurance counselor to search the database by ZIP code, county or state and compare local plans' benefits and fees. More than 16 percent of all Medicare beneficiaries already belong to private health plans known as HMOs networks of doctors, hospitals and other care providers whose work is coordinated by an insurance company. The plans agree to accept a standard monthly fee from the government for each Medicare patient, no matter how much medical attention they need. Other types of plans will become available starting in 1999. In addition to being added to Medicare's Internet database, information about them will be mailed to every Medicare beneficiary in the fall. Medicare will also set up a toll-free counseling hot line next winter. "In each community the choices will be different," depending on what health care companies offer, said Bruce M. Fried, director of Medicare's Center for Health Plans and Providers. New plans will include: Provider Sponsored Organizations, or PSOs, which are managed care plans run by doctors and hospitals directly, instead of insurance companies. Preferred Provider Organizations, or PPOs, which are plans that allow visits to doctors outside the managed care network, usually at an additional charge. Private fee-for-service, in which Medicare will pay a standard fee to the private indemnity insurance plan of a beneficiary's choice. The beneficiary pays any additional fees charged by the plan out-of-pocket. Medical Savings Accounts, or MSAs, which up to 390,000 seniors will be able to try on an experimental basis. They will get a cash benefit paid into a tax-free account to be used for health care expenses.
(02 Jan 1998 07:19 EST)
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| In Other News |
Friday Jan. 2, 1997
• Sources: Clinton To Propose Major Medicare Expansion |
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