Senior Solutions: Changes in store for Medicare

Q. What new preventive benefits will Medicare offer as a result of the legislation?—Brenda W.

A. Starting in 2005 ,Medicare will expand the preventive benefits it offers to its enrollees. This may be another good reason to stay with traditional Medicare. These new benefits will include:

a. Blood test for early detection of cardiovascular diseases;

b. Diabetes screen test; and

c. Physical exams for initial enrollment in Part B.

Q. My insurance company already offers me a free prescription drug card. Why do I need another from Medicare?—Marilyn D.

A. Good question. I cannot answer it without knowing more of your situation. It could very well be that you do not need a new card. Some insurance companies are discussing providing a free Medicare-approved card to their customers. You should visit with your agent and/or company to determine if one will be made available.

Q. Do I have to give up Medicare if I elect to go with an HMO?—Alexander R.

A. This question is asked a lot. I will oversimplify—yes and no. Yes, you opt out of Medicare benefits. No, you do not entirely leave the Medicare system. HMOs normally contract with the government to provide services to Medicare recipients. This is a good deal for the government as it relieves much of the administration burden. In theory, HMOs can offer benefits equal to those of Medicare, as they contract with providers at discounted rates. The down side has been limited access to providers. When electing an HMO to provide services, you in effect give up your right to participate in Medicare benefits. You will still be charged a premium for Part B and soon Part D if you elect an HMO. This helps generate the revenue stream necessary to pay for the services of the HMO. Keep in mind that if after electing an HMO, you determine to go back to traditional Medicare, you must notify Medicare by disenrolling from the HMO and re-enrolling in Medicare.

Peter Gulatto has been associated with the insurance industry for more the 30 years. He has held a Certified Insurance Counselors (CIC) designation since 1983. His responsibilities have included those of an insurance agent, risk manager, consultant and insurance educator. His interest now is focused on providing answers to the insurance challenges facing our senior population.

Submit your questions to Peter J. Gulatto C/O The Centurion Group Inc. P.O. Box 3333, Rockford, IL 61106, or call at 815-229-0994.

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