Medicare HMOs abandoning half a million senior citizens

Rattled by being cut from their health plans, some seniors might seek advice from doctors about their Medicare options.

By Geri Aston, AMNews staff. Oct. 8, 2001.

Washington -- For the fourth consecutive year, dozens of health plans are exiting Medicare entirely or deserting specific markets, leaving hundreds of thousands of confused beneficiaries behind and potentially upsetting some physician-patient relationships.

The Centers for Medicare & Medicaid Services announced last month that 58 health plan contracts are involved in the latest withdrawal, with 22 being pulled from Medicare+Choice completely and 36 leaving certain markets.

About 536,000 beneficiaries will be affected once the withdrawals take effect Jan. 1, 2002. Their choices will be to go back to the traditional fee-for-service Medicare program or find another health plan, although for about 38,0000 beneficiaries, there will be no other Medicare-participating HMO in their area to join.

"The problem is going to be more for patients than for doctors," said Henry E. Jacobs, MD, president-elect of the Hartford County Medical Assn. More than 14,000 beneficiaries in that Connecticut county are reportedly being dropped from one health plan. "Doctors are already acclimated to the fact that it's a losing proposition for us, but patients have expectations about their health care," he said.

For seniors, being dropped from their health plan "usually means a struggle to figure out what to do to get the health care they need at an affordable price," said Diane Archer, president of the Medicare Rights Center, a New York City-based consumer group.

The result is "high levels of anxiety, high levels of confusion," said Tricia Neuman, ScD, who is the director of the Medicare Policy Project at the Kaiser Family Foundation. "They feel like they've lost their health insurance." [...]