HMOs Now Offered Through Medicare

Older Americans now have greater freedom of choice and savings on health care plans, according to Sen. John Heinz (R-Pa.).

Regulations recently completed by the Administration will “open the door for 29 million Medicare beneficiaries to enroll in a health maintenance organization (HMO), with Medicare picking up the monthly fee,” said Heinz, chairman of the Senate Special Committee on Aging.

Until now Medicare did not cover the cost of membership in an HMO because it required a prepayment of fees for care, according to Heinz.

HMOs provide members with comprehensive health care benefits including the services of a physician, hospital, laboratories, X-rays and physical therapy. A prepaid monthly fee is a “sure-fire incentive to keep a lid on costs,” Heinz said.

Under the new regulations, participation in an HMO is entirely voluntary, with full health care protection under Medicare guaranteed in any case, Heinz said.

“Prepaid medical plans offer a way out of the forest of specialists, institutions and claims forms,” Heinz said. “Too often seniors postpone care to avoid the added cost and added headache of yet another doctor, still one more test.”

For an HMO to qualify for Medicare enrollees, its coverage must at least equal that of a regular Medicare plan.