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STORIES ON HEALTH
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MEDICARE SUPPLEMENT:
CLOSING THE GAPS
By Kathy Feeny, Executive Vice President, Secure Horizons Senior
Solutions
For years, Medicare beneficiaries have seen their
coverage options dwindle and their health care costs skyrocket.
Despite stop gap measures to control the aging system’s red ink,
Medicare may soon collapse under the crushing weight of nearly 78
million Baby Boomers – now approaching retirement and ready to join
the program. Ultimately, the federal government must overhaul and modernize
Medicare to reflect this new reality. This, clearly, will take some
time. In the short term, Congress and the president should act to provide
relief to
the 40 million seniors now enrolled in Medicare. As the cost of
health care continues to rise, coupled with inadequate funding from
the federal government, many Medicare+Choice HMOs have been forced
to raise premiums, limit benefits or leave some areas altogether. In
2002, about 536,000 Medicare+Choice beneficiaries faced disruptions
in their health coverage, according to the Centers for Medicare and
Medicaid Services (CMS). Seniors have had little choice but to
revert to original, “fee-for-service” Medicare as their only option,
one that still does not offer a
prescription drug benefit. Seniors, most of whom live on a fixed income, spend an increasing
share of their disposable income on health care. According to the
National Health Policy Forum (NHPF), Medicare beneficiaries spent an
average of $3,142 out of their own pocket, or 22 percent of their
income, on health care expenses in 2000. Considering the fact that
the cost of medical care and prescription drugs soars 8 to 10
percent and 12 to 15 percent, respectively, each year, and that
Medicare pays for only 55 percent of the health care costs of the
elderly, the time to provide seniors affordable and
flexible health care options is now.
In the meantime, Medicare-eligible seniors have an option in
Medicare supplement, or “Medigap”, plans that cover Medicare’s gaps,
such as deductibles,
co-payments and prescription drugs.
Medicare supplement plans allow
seniors to continue with the doctor of their choice. Because their
plans do not have geographic restrictions, seniors can to
travel freely, knowing that their plan will cover them. Medicare
supplement plans also provide policyholders the security and peace
of mind that comes with knowing that many of their Medicare
co-payments and deductibles are covered.
Supplemental coverage also
may include value-added programs, such as discounts for
prescriptions, over-the-counter medications, vision, hearing and
referral resources, as well as alternative medical treatments, such
as
chiropractic and acupuncture services.
Seniors interested in enrolling in a Medicare supplement plan should
consider the following:
- Figure the costs incurred over the past year for health care. Can
those be reduced through a supplement plan?
- If original Medicare is the only
option available, will a Medicare supplement plan help make the
coverage more complete?
- Do the covered parties travel
often?
- How do current prescription drug
benefits compare with other plan options?
Since Medicare supplement plans offer more options, seniors should
evaluate their needs carefully. Seniors should obtain information on
all the alternatives to
original Medicare. The task can be daunting, but there are resources
to help. Help is available for seniors who aren’t sure which plan is right
for them. Medicare beneficiaries should contact their local SHIP
(State Health Insurance Assistance Program) at
702-486-3796 or
e-mail at nvship@aging.state.nv
Trained and registered SHIP
counselors are available to help seniors compare health insurance
policies and explain what services each one can
provide. It should be noted, however, that SHIP does not sell,
endorse, or recommend any specific insurance. Counseling is
confidential and free of charge.
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