Perspective               

Bill Introduced to Eliminate Implementation of Lock-In

If you are in a Medicare HMO, you need to know that starting January 1, 2002, you can make only one health plan change from January through June 2002, either to another Medicare HMO or to Original Medicare. After June 30, 2002, you will not be allowed to leave your Medicare health plan for the rest of the year. This means that if you're in a Medicare HMO and your doctor leaves the HMO, after June 30 you will not be able to leave the HMO in order to continue to get care from your doctor.

Congressman Fortney Stark (D-California) has introduced legislation that would eliminate this rule and allow you to leave your Medicare plan whenever you want. The legislation would also outlaw Medicare HMOs from charging you more for a medical service than Original Medicare would charge you. And, the law would give you the right to buy insurance that fills gaps in Original Medicare, sometimes called Medigap insurance, if your HMO changes benefits or your doctors or hospitals leave the HMO.

People with Medicare value continuity of care from doctors they know and trust and the ability to access covered care anywhere in the country. A law that would force you to stay in your HMO could undermine your ability to get the care you need. Moreover, many people in Medicare HMOs and those considering joining HMOs are not aware of the new limits on their ability to switch Medicare plans. A recent Medicare Rights Center study found that Medicare HMOs are giving out incorrect information about the rights of people with Medicare to enroll and disenroll from a Medicare HMO in 2002. The study found that 80 percent of Medicare HMOs surveyed across the country (16 out of 20) gave out misinformation about the lock-in rule. [To read the study, click here.]

If you want to continue to be able to switch your Medicare plan throughout the course of the year, contact your members of Congress and let them know.

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