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Medicare options -- Which plan to choose?
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| A Medicare Internet site provides extensive health plan comparison information for seniors. |
February 3, 1999
Web posted at: 5:36 p.m. EST (2236 GMT)
From Health Correspondent Eileen O'Connor
WASHINGTON (CNN) -- As President Clinton unveils more ideas on reforming Medicare, the administration is already touting the newly operational Medicare Plus Choice Plan, through a government-sponsored Web site.
Some studies show less than 12 percent of seniors use the Internet, so the American Association of Retired Persons is distributing a booklet on the pros and cons of each option.
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TRADITIONAL MEDICARE | MANAGED CARE |
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Payment |
The government pays for services your doctor deems necessary, so there's no incentive to restrict them. |
Managed care plans get a set fee from the government, so there is financial incentive to restrict services. |
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Out-of-pocket expenses: |
Seniors must pay when charges exceed set limits. Some use employer retiree insurance or Medigap to cover those costs. |
Those covered by HMOs pay little or no out-of-pocket fees, but only for care approved by the plan. |
| Choice: |
Patients can choose almost any doctor or hospital in the United States -- something patients who travel or who need specialists must consider. |
Managed care programs have more restrictions, but the patient can choose among a network of hospitals and doctors, and some costs outside the plan may also be covered. |
| Additional benefits: |
Traditional Medicare does not pay for most prescription drugs, vision care or earring aids. |
Managed care usually pays for these things. |
| ALSO: Medicare Health Plans |
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"Do you have prescription drug needs or extensive prescription drug need; do you have the need of a specialist? -- those kind of questions become very important for deciding," said Patricia Smith of the AARP.
AARP cautions that some managed care plans have dropped seniors, though managed care groups say they are trying to prevent that.
"We are working very concertedly with members of Congress, and with beneficiaries and employers to try to achieve a midcourse correction that will continue to make available to seniors the HMO/managed care option which really is the foundation of any long-term reform that Congress might undertake," said Susan Pisano of the American Association of Health Plans.
Many local senior groups offer workshops explaining the plans, and Medicare officials say these are the best places to find out more.
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