HMOS TO DROP MANY OF ELDERLY.Byline: Robert Pear The New York New York, state, United States New York, Middle Atlantic state of the United States. It is bordered by Vermont, Massachusetts, Connecticut, and the Atlantic Ocean (E), New Jersey and Pennsylvania (S), Lakes Erie and Ontario and the Canadian province of Times Health-maintenance organizations, once thought to be the hope for the future of Medicare, said Thursday they will drop tens of thousands of beneficiaries next year, partly because the Clinton administration Noun 1. Clinton administration - the executive under President Clinton executive - persons who administer the law has refused to let them raise premiums or cut prescription-drug coverage for the elderly. Spokesmen for the industry said the organizations will withdraw health plans from 300 counties in 18 states because medical costs were higher and Medicare payments lower than anticipated. Such cutbacks would affect about one in 20 Medicare beneficiaries now enrolled in HMOs. The White House and the Department of Health and Human Services Noun 1. Department of Health and Human Services - the United States federal department that administers all federal programs dealing with health and welfare; created in 1979 Health and Human Services, HHS rejected a last-minute lobbying blitz by the HMOs, which sought permission to increase premiums, raise co-payments or limit certain costly benefits, such as prescription drugs prescription drug Prescription medication Pharmacology An FDA-approved drug which must, by federal law or regulation, be dispensed only pursuant to a prescription–eg, finished dose form and active ingredients subject to the provisos of the Federal Food, Drug, . Today is the deadline for HMOs to say whether they will participate in Medicare. Karen Ignagni, president of the American Association American Association refers to one of the following professional baseball leagues:
Consumers dropped from HMOs have two basic options. They can go into the traditional fee-for-service Medicare program, with or without supplementary insurance to cover extra items, or they can enroll in another HMO HMO health maintenance organization. HMO n. A corporation that is financed by insurance premiums and has member physicians and professional staff who provide curative and preventive medicine within certain financial, if one is available. Advocates for the elderly said the turmoil and uncertainty could deter people from joining HMOs. ``HMOs have left the Medicare market in the past, but far fewer people were affected,'' said Cheryl Matheis, a lobbyist for the American Association of Retired Persons American Association of Retired Persons: see AARP. . ``The knowledge that HMOs can and do leave the program may make people a little wary about going into these plans in the future. Beneficiaries do not want to be changing health plans every year. They like stability. ``Many of these beneficiaries will have higher out-of-pocket medical costs if they have to buy supplementary insurance, and they may not have coverage of prescription drugs.'' The association, using government data, said Medicare beneficiaries paid an average of $104 a month last year for supplementary Medigap policies. Medigap plans that cover drugs often cost much more. ``Beneficiaries leaving HMOs may be unable to get insurance to fill gaps in the traditional Medicare program because of their health, their age, the cost or other factors,'' said Diane Archer, executive director of the Medicare Rights Center in New York City New York City: see New York, city. New York City City (pop., 2000: 8,008,278), southeastern New York, at the mouth of the Hudson River. The largest city in the U.S. . Medicare finances care for 39 million people who are elderly or disabled. About 5.9 million of them are in HMOs, and the number has been rising rapidly. But Ignagni said that Aetna, Prudential, Allina, Anthem, Pacificare, Humana, Intermountain in·ter·moun·tain adj. Located between mountains or mountain systems, especially lying between the Rocky Mountains and the Sierra Nevada or Cascade Range in the western United States. Health Care and other HMOs are scaling back their Medicare operations. |
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