Seniors’ coverage options dwindle as Medicare Advantage programs close shop


Bob Moos of The Dallas Morning News reports:
Stu Stoler was beside himself when his private Medicare Advantage plan notified him that it’s closing at year’s end. The 68-year-old Lewisville resident has liked his coverage, especially the lack of co-payments for his insulin.
“I’ve now got to find something else that fits my needs and that I can afford,” he said.
In shopping for a plan that will cover hospital stays, doctor visits and prescriptions, the retired salesman has attended an insurer’s sales presentation, called companies’ customer service lines and invited sales reps to his home to hear their pitches.
“It’s still confusing,” Stoler said. “These plans have lots of moving parts. They’re a challenge to compare.”
Medicare’s annual enrollment period runs until Dec. 31. Although most Medicare beneficiaries will focus on their drug coverage, they will also have time to review their hospital and physician coverage and make changes if they wish.
In recent years, over 10 million beneficiaries, or more than 20 percent of those on Medicare, have chosen private Medicare Advantage health plans over the government’s traditional fee-for-service program.
The plans are essentially a private version of Medicare. Instead of paying beneficiaries’ claims directly, the government pays insurers such as UnitedHealthcare and Humana Inc. to oversee the health care of seniors and people with disabilities.
The plans have caught on with seniors on fixed incomes because they typically combine hospital and physician coverage with additional benefits such as prescription drug insurance, preventive medical care, dental services and vision coverage.
Still, consumer advocates caution beneficiaries that the private Advantage plans may not be as comprehensive as the private “Medigap” policies that people often buy to supplement Medicare’s regular fee-for-service coverage.
Nationally, beneficiaries will select from an average of 35 Advantage plans in urban areas and 24 plans in rural areas for 2010, about 18 percent fewer than for 2009, according to the Kaiser Family Foundation.
In Dallas and Collin counties, beneficiaries will pick from about 50 plans for 2010, down from about 60 this year.

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