New “Lock-In” Law Threatens Older And Disabled Americans' Access To Health Care

[Guest guest]

New " Lock-In " Law Threatens Older And Disabled Americans' Access To

Health Care

http://www.medicalnewstoday.com/medicalnews.php?newsid=46274

Beginning this weekend, older and disabled Americans who are enrolled

in a Medicare private health plan will be required by law to stay in

their plan until the end of the calendar year. In 2007 and beyond,

they will be locked into plans beginning April 1.

" People with Medicare will be trapped in private health plans that

are hazardous to their health if Congress does not lift the `lock-in'

law, " said M. , president of the Medicare Rights

Center. " Getting out of Medicare HMOs and back to Original Medicare

has often been the remedy for people who hit road blocks when they

needed health care, or discovered they had large, unexpected costs

when they got sick. "

People with Medicare will be locked into their health plan regardless

of whether the plan meets their health care needs or they can afford

the plan's out-of-pocket costs, reports the Medicare Rights Center, a

national consumer service organization. People victimized by high-

pressure marketing techniques and misinformed about managed care

restrictions will also be locked into their plans.

Using numerous case examples, the Medicare Rights Center's report,

Elimination of Plan Lock-In: A Vital Consumer Protection, illustrates

how disenrollment from a Medicare HMO and return to Original Medicare

preserves consumer choice of doctors and hospitals, and has been an

essential counter-measure to inappropriate marketing, unexpected high

cost-sharing, health plan network restrictions, and unjustified

denials of coverage for care.

" People duped into joining HMOs by savvy marketing representatives

should not have to suffer the consequences of being locked into the

wrong health plan, " said Mr. .

The Medicare Rights Center reports that about 25 percent of the

Medicare HMO cases it has handled between January 2004 and June 2006

involved denials of medical care by HMOs, with durable medical

equipment, diagnostic services and emergency care comprising the

majority of denials. Less than 9 percent of people in Original

Medicare called about a denial in the same period. About 5 percent of

the HMO callers expressed an intention to disenroll from their plan.

About 12 percent of people with Medicare are enrolled in private

health plans, primarily HMOs, according to the Kaiser Family

Foundation.

The Medicare Rights Center's report Elimination of Plan Lock-In: A

Vital Consumer Protection is available at

http://www.medicarerights.org/lockin_0606.pdf.

The Medicare Rights Center, founded in 1989, is the largest

independent source of information and assistance on health care

rights and benefits for older and disabled men and women in the

United States.

For more information about MRC, call 212-204-6219, or visit the MRC

web site: http://www.medicarerights.org.