REPORT CHECKS HMOS' VALUE SENIORS MIGHT NOT GET MONEY'S WORTH.

Byline: Dana Bartholomew Staff Writer

Los Angeles seniors who shell out more for expensive HMO Medicare insurance don't always get the best value for their buck, according to a study to be released today.

While HMO alternatives to traditional Medicare tout costly drug prescriptions as one reason to sign up, the 40-page report concludes such coverage is inconsistent, or not available at all. The report done by the California HealthCare Foundation and Consumer Union, publisher of Consumer Reports, is geared toward seniors making tough decisions and is the first county-by-county breakdown of HMO Medicare benefits in the nation.

``There's clearly a difference in plans offered,'' Trudy Lieberman, director of Consumer Union's Center for Consumer Health Choices, said of the study. ``Just because it costs more, doesn't mean it offers the best value for your money.''

The results might surprise the more than a million Medicare beneficiaries in Los Angeles County, of which roughly 400,000 subscribe to HMO plans.

PacifiCare's Secure Horizons Basic Plan (which rated two stars out of a potential five, the lowest score in Los Angeles County) charges $100 a month and $15 at the doctor's office - and offers no drug prescription benefits. PacifiCare's basic plan scored the worst in Ventura County, with one star.

Kaiser Permanente's Senior Advantage, which was rated the best drug pick in L.A. County, charges $30 a month and $12.50 at the door - and offers unlimited drug benefits.

In Los Angeles County, the overall value winner, UHP Healthcare for Seniors, charges nothing each month and nothing at the door. It is rated above-average in customer satisfaction - and below average in ease of doctor referrals. Four other programs in the county scored five stars.

Kaiser's plan - which earned four stars along with PacifiCare's Secure Horizons Standard Plan I - was named best bet in Ventura County.

The most generous HMO plans were found to pay about two-thirds of a typical senior's hefty prescription costs.

``Because of their low cost and expanded benefits, HMOs may be the best choice for many Medicare beneficiaries,'' Lieberman said. ``It's an option seniors should definitely consider.''

Insurance industry officials and consumer advocates alike praised the Consumer Report study - but cautioned readers to look beyond the ratings and consider whether their doctors, and prescriptions, were included in any specific plan.

``This is a nice overview,'' Aileen Harper, executive director for the Center for Health Care Rights in Los Angeles, which helps seniors select health insurance plans, said after looking at the report. ``But people need to look beyond the stars a plan has.''

Bobby Pena of the California Association of Health Plans, an HMO industry arm, agreed. ``The caution is: Don't take this as your only source,'' he said.

While Kaiser and UHP Healthcare officials were elated at their ratings, PacifiCare officials said their Basic Plan wasn't so basic, but was a basis for corporations to add retirement coverage.

``This is great,'' said PacifiCare Secure Horizon spokesman Tyler Mason, reviewing the colorful document with oversize print. ``It would be wonderful if they put this out four or five years ago when there were more (HMO) options in California.''

On the other hand, he said, ``I think it's hard to line us up like a consumer product like cars and toasters - you really have to do your homework.''

The free report, called ``Guide to California Medicare HMOs: All Medicare HMOs are Not Alike,'' offers six steps to choosing an HMO, as well as various tables ranking Consumer Reports' best picks in each county for overall value, lowest office visit co-payment and lowest monthly premium.

A new version will be published in January prior to HMO beneficiaries being ``locked in'' to their plans because of new federal regulations next summer. After six months, seniors insured under the HMO Medicare-Plus option can select a new plan.

-- The Consumer Reports HMO study is available on the Internet at www.chcf.org or www.consumerreports.org, or by calling [phone].

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WHICH MEDICARE HMOs OFFER THE BEST VALUE?

Comparing HMOs in Los Angeles County

SOURCE: California Health Care Foundation