Search
Close this search box.

New Medicare Handbook Due Soon, But May Be Confusing

Print Article

JUNE 15, 1998 VOLUME 5, NUMBER 50

Thirty-eight million individuals now receive their medical care through the federal Medicare program. The Health Care Financing Administration (HCFA), which manages the Medicare program, is busily preparing a new, $40 million version of its annual handbook for Medicare recipients, which will shortly be available to participants, providers and advocates. This year, however, because of the new Medicare options created by Congress in its last session, there will be over 500 versions of the Medicare handbook, and officials say they expect more confusion on the part of participants after they have read the new explanations.

HCFA has tried out early versions of the handbook on groups of Medicare beneficiaries, and reports that even well-educated recipients have trouble understanding the choices. One sample explanation:

“If you had a supplemental policy and dropped it to enroll in a Medicare managed care plan, or Medicare Select policy for the first time, and you choose to disenroll from the Medicare health plan or Medicare Select policy within 12 months of enrolling, then you can go back to the Medigap policy you had before joining the Medicare health plan, if it is still offered, or purchase Medigap policies A, B, C or F. This protection is available ding the 63 days after leaving the health plan.”

The reason for the confusion (and the confusing language) is simple: there are five new plan options which must be explained to participants. Because several of those options rely on private insurance plans, not all of them will be available in every area of the country. In addition to traditional fee-for-service Medicare, participants will now be able to choose from among:

  • Medicare HMOs. This option has been available for several years, and in fact six million Medicare beneficiaries are already enrolled in HMOs. Congress predicts that number will grow to seventeen million in the next ten years.
  • HMO with “Point-of-Service” option. Patients may enroll in a Medicare HMO, but retain the right to go outside the plan’s list of physicians and hospitals if and when they are willing to pay extra.
  • Preferred Provider Organizations (PPOs). Beneficiaries may visit any physician or hospital, but will pay less when they use the services of participating providers.
  • Provider-Sponsored Organization. Physician groups and hospitals may join together to offer a combined plan to participants, who will receive most of their services from the participating providers.
  • Private Fee-for-Service. Essentially private insurance, with Medicare providing a portion of the premium coverage. Participants would be permitted to use any provider, but may pay higher premiums for the plan because the government does not limit fees or services.
  • Medical Savings Accounts. Participants purchase insurance to cover only catastrophic illnesses, and Medicare pays the premium, then deposits the rest of the participants’ benefit into a savings account. If routine medical costs exceed the funds in savings, participants will have to pay from their own pockets.

While the variety of plans is intended to lead to more consumer choice, administration officials warn that it will also lead to more confusion. HCFA officials estimate that they will need over 2,000 workers just to answer telephones during the busiest times of day after the distribution of the Medicare handbook.

Congressional staffers also predict that their offices will be flooded with calls from confused constituents. They may be uniquely qualified to answer callers’ questions–after all, Congress created the new choices last year, and will now find itself in the position of explaining them.

Stay up to date

Subscribe to our Newsletter to get our takes on some of the situations families, seniors, and individuals with disabilities find themselves in. These posts help guide you in the decision making process and point out helpful tips and nuances to take advantage of. Enter your email below to have our entries sent directly to your inbox!

Robert B. Fleming

Attorney

Robert Fleming is a Fellow of both the American College of Trust and Estate Counsel and the National Academy of Elder Law Attorneys. He has been certified as a Specialist in Estate and Trust Law by the State Bar of Arizona‘s Board of Legal Specialization, and he is also a Certified Elder Law Attorney by the National Elder Law Foundation. Robert has a long history of involvement in local, state and national organizations. He is most proud of his instrumental involvement in the Special Needs Alliance, the premier national organization for lawyers dealing with special needs trusts and planning.

Robert has two adult children, two young grandchildren and a wife of over fifty years. He is devoted to all of them. He is also very fond of Rosalind Franklin (his office companion corgi), and his homebound cat Muninn. He just likes people, their pets and their stories.

Elizabeth N.R. Friman

Attorney

Elizabeth Noble Rollings Friman is a principal and licensed fiduciary at Fleming & Curti, PLC. Elizabeth enjoys estate planning and helping families navigate trust and probate administrations. She is passionate about the fiduciary work that she performs as a trustee, personal representative, guardian, and conservator. Elizabeth works with CPAs, financial professionals, case managers, and medical providers to tailor solutions to complex family challenges. Elizabeth is often called upon to serve as a neutral party so that families can avoid protracted legal conflict. Elizabeth relies on the expertise of her team at Fleming & Curti, and as the Firm approaches its third decade, she is proud of the culture of care and consideration that the Firm embodies. Finding workable solutions to sensitive and complex family challenges is something that Elizabeth and the Fleming & Curti team do well.

Amy F. Matheson

Attorney

Amy Farrell Matheson has worked as an attorney at Fleming & Curti since 2006. A member of the Southern Arizona Estate Planning Council, she is primarily responsible for estate planning and probate matters.

Amy graduated from Wellesley College with a double major in political science and English. She is an honors graduate of Suffolk University Law School and has been admitted to practice in Arizona, Massachusetts, New York, and the District of Columbia.

Prior to joining Fleming & Curti, Amy worked for American Public Television in Boston, and with the international trade group at White & Case, LLP, in Washington, D.C.

Amy’s husband, Tom, is an astronomer at NOIRLab and the Head of Time Domain Services, whose main project is ANTARES. Sadly, this does not involve actual time travel. Amy’s twin daughters are high school students; Finn, her Irish Red and White Setter, remains a puppy at heart.

Famous people's wills

Matthew M. Mansour

Attorney

Matthew is a law clerk who recently earned his law degree from the University of Arizona James E. Rogers College of Law. His undergraduate degree is in psychology from the University of California, Santa Barbara. Matthew has had a passion for advocacy in the Tucson community since his time as a law student representative in the Workers’ Rights Clinic. He also has worked in both the Pima County Attorney’s Office and the Pima County Public Defender’s Office. He enjoys playing basketball, caring for his cat, and listening to audiobooks narrated by the authors.