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CONSUMERS: Medicare Part D … as in Detail by Mr Jib

The Sacramento Bee has a good article which exposes a little detail which may be important to people who are thinking about signing up for Medicare Part D.  It turns out that people who are in managed care plans and sign up for a free standing drug plan with a different company may find their existing coverage terminated.  According to the Bee:

Seniors who are members of managed care health plans and then enroll in a drug plan offered by another organization could be dropped from their health plan, according to health plan and Medicare officials. Marketing campaigns for Medicare’s new prescription drug benefit plans are set to start Saturday. Advocates for seniors are worried that the benefits will be attractive enough to get seniors to sign up without first calling their HMOs.

From the managed care plan’s perspective, signing up for a drug plan offered by another managed care plan is seen as a decision to leave…

Oh. And Medicare Part D. marketing starts Saturday. 

Go read the article.

Mr Jib

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7 replies »

  1. //somebody care to explain the economics of that?//
    I have a theory! All they have to do is answer no calls, letters, etc. I’ve had that problem in all my dealings with the health care system (Highland hospital and Alta Bates/Summit in the Bay Area). They don’t answer calls, faxes, or emails. Then they make their money by selling “debt” to collections agencies. These insurance companies will just keep the $1.95 (which compounds like the nickel for every time you swear), and let the hospitals sell the debt.

  2. According to the NYT over the weekend, Humana is offering a plan in the Midwest which has a monthly premium of about $1.95. Would somebody care to explain the economics of that?
    I’m assuming this is a way to drum up sales for other business areas. I wonder what the fine print has to say.

  3. I’m proud to say we have been writing about this phenomenon at HealthLeaders for months. Unfortunately, we’re not on the main-stream media’s must-read list.

  4. If your Grandma is paying $1,000 a month on Rx just tell her that the most she will pay with Rx coverage is $3,600 a year so she will save over $8,000 in 2006.
    Tell your Grandma that President Bush promised Rx coverage in Medicare and he delivered so she should vote Republican from now on.

  5. While all of the conditions and choices for signing up for Part D might be confusing to me, I’m sure my 89 year old Grandma will be able to navigate them like a hot knife through butter. It will be “empowering” for her.

  6. Wow, another reason to hate that health care has been thrown to the wolves of the market forces.
    A friend of mine just told me about another hinky practice. She is poor (temp employee with sporadic work), and she has no insurance. She pays in cash to see a doctor. The doctor makes her sign a privacy-release which allows him to share her information with insurance companies.
    The effect of this is to discourage my friend from sharing symptoms of new problems with her doctor. If she says anything about a new problem, it will be called “pre-existing” if she ever gets insurance. Therefore, she has to present the symptoms of old, already documented problems in order to get the medication she needs for the current one.
    If the doctor is well aware of this, it’s also a strategy for him to avoid documentation, and therefore both liability and responsibility for treatment. I think this is a workaround for the hippocratic oath. (re: technically, the patient never told me there was a problem!).
    As usual, all about business, nothing about the benefits to society that could be accrued from keeping people healthy.

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