Medicare benefits changing in Washington County

December 22, 1998|By LAURA ERNDE

Time is running out for the 1,100 Washington County Medicare recipients who are being dropped by their managed care plans at the end of the month.

To keep similar benefits, they must choose another managed care plan, at a cost of $75 a month, or buy supplemental Medigap insurance.

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Those being dropped should have been notified by their insurance company last month.

"I fear people out there do not realize or are not aware of the situation they're in," said Katrina Eversole, health insurance advocate at the Washington County Commission on Aging.

The changes do not effect people in Franklin County, Pa., or the Eastern Panhandle of West Virginia, who have not yet been offered managed care plans.


In Washington County, if those who are being dropped do nothing, they won't lose coverage. They will automatically be enrolled in the traditional Medicare plan.

But they could be losing out on extra benefits such as prescription plans, Eversole said.

Medicare recipients affected by the changes have had to do a lot of homework to find out what plan is best for them.

Richard Smith, 67, of Sharpsburg, has used the World Wide Web to answer many of his questions.

But the retired computer professional has also been angered by a lot of the information he has found.

"The rural counties are being treated unfairly when it comes to availability of health care," he said.

People in rural areas have fewer health care plan options. Or the same benefits that cost Washington County residents $75 a month are being offered free to people in metropolitan areas, he said.

The reasons are complex, but it basically boils down to a business decision, according to the federal Health Care Financing Administration said.

It's more expensive to offer managed care in rural areas with fewer patients and fewer hospitals.

"I think that's an insult to people who need medical care. It's not a commodity to be traded on the stock exchange," Smith said.

Smith has lobbied U.S. Rep. Roscoe Bartlett and Senators Barbara Mikulski and Paul Sarbanes to do something about the disparity.

"They'll tell you what the problems are, but they won't tell you the solutions," he said.

Last January, Del. John P. Donoghue proposed a law that would prohibit managed care companies from charging rural residents a premium for Medicare-replacement benefits while others living in metropolitan areas pay nothing.

The bill was killed by the Economic Matters Committee, but Donoghue said he will work with federal officials to get better managed care choices for Washington County Medicare recipients.

While there is no guarantee of better choices, there's likely to be more choices as the federal government implements its Medicare+Choice plan.

"Our area is growing and changing," said Eileen Dooley, executive director of Berkeley Senior Services in Martinsburg, W.Va.

Dooley said Tri-State Area residents would be better off if managed care companies were allowed to offer plans across state lines. So far, differing state regulations have prevented that, she said.

Some worry that the managed care options will get more expensive.

"That's a real valid fear that next year we'll be facing another crisis," Eversole said.

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