Choosing A Specific Medicare or Medicare HMO Plan for You

Part 3, Chapter 11: Medicare and Medicare Related Programs: Medicare HMO's Page 4

Continued from Previous Page

The rules that deal with the right of a Medicare beneficiary to choose a specific Medigap policy differ from state to state. Given that situation, it may be a good idea for Medicare beneficiaries who have a Medigap policy when they join a Medicare HMO to maintain that policy temporarily until they are certain that the Medicare HMO will fully meet their needs and that they want to remain in the HMO on a permanent basis. During that period of time, the Medicare beneficiary will have an opportunity to evaluate the coverage offered by both the HMO and the Medigap policy, and can make a logical determination in terms of whether the coverage offered by the Medigap policy is likely to be beneficial in the long run.

Many members of Medicare HMOs report a high level of satisfaction with the program in which they're enrolled. However, there have also been reports of problems. The government is currently in the process of reviewing the possibility of developing a system for evaluating Medicare HMOs. If that system is established, it should make it much easier to decide whether a Medicare HMO is appropriate for you. Since it's likely to be several years before the system is in place, you'll need to rely on your own research in the meantime. Before making any decision, it's essential to compare several Medicare HMOs, to discuss the rules with program representatives, and to talk with HMO members about their experiences.

Summary

The decision of whether to stay with the traditional Medicare plan or to join a Medicare HMO is an important one. The question of which HMO to join is equally important. Before making any decision, it's essential for Medicare beneficiaries to research a variety of Medicare HMOs and to compare those choices with the advantages and disadvantages of staying with the traditional Medicare plan.

Continue to Part IV