What About Medicare HMO’s?

Let’s say that you are a retiree whose old employer has just dropped your prescription coverage and you hastily enrolled in a Medicare HMO thinking that you would be well covered.  Now you have many doubts.  How do you determine if you made a wise choice in your Medicare HMO coverage?

This is a question that many people are asking these days and have been asking as they have experienced this type of change in their medical coverage.  It is important to look into the HMO – hopefully before you enroll – to see how much coverage you have and how and where it covers you.  For instance, many HMOs only cover you close to home, particularly in nearby counties, or within your state, except for emergencies.

Usually your HMO will cover what your old policy covered, but not always. If you are not sure about this, there are places to ask questions.  First of all, you can always get in touch with the Centers for Medicaid and Medicare Services (CMS).  They have information on plans being offered, as well as comparisons of coverage.  You can also contact an organization called SHINE – Serving Health Insurance Needs of Elders, a program of trained volunteers working in the state of Florida Department of Elder Affairs and other agencies on aging. 

These volunteers are qualified to give information about Medicare health pan choices, eligibility, enrollment and coverage; supplemental (Medigap) insurance and the issues attached to it, appeal rights, long term care and prescription assistance, including Medicare prescription plans.

Having informed and trained individuals to talk to about benefits that can protect your income and assets, as well as your health, is a very important and vital opportunity.  If an individual can make informed choices and feel comfortable with those choices, it is essential, and it will help people put themselves into a position where it is easier to stay healthy because they understand – and can access – services they are entitled to. 

Most states have some type of organization providing information.  To get the contact information, contact CMS at 1-800-MEDICARE, AARP, or call SHINE in Florida at 1-800-262-2243 or 1-800-963-5337.  Get the accurate information yu need to make the choices that are necessary.