Special Report: Changing Medicare

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New Medicare Rule Could Catch Millions By Surprise

Listen to Julie Rovner's report.

Dec. 11, 2001-- Medicare beneficiaries are supposed to be spending this month choosing how they will get their health care next year. They can stay in the traditional, government-run program, or opt for a private plan, like an HMO. Until now, making the wrong choice was no big deal. Unlike most of those in the working world, Medicare beneficiaries could switch plans every month. But NPR's Julie Rovner reports, that's about to change.

About 6 million Medicare beneficiaries get their care from private health plans, mostly HMOs. That group will be the most affected by a new rule known as "lock-in."

Starting next year, beneficiaries will be allowed to change plans only once between January and the end of June. After that, they won't be able to change again until January 2003. Aileen Harper, who counsels Medicare patients at the Center for Health Care Rights in Los Angeles, says that for many beneficiaries, that's going to be a rude surprise. She says most beneficiaries don't have a clue that the change is coming ...

Changes in Medicare Benefits Leave Many Confused

Listen to Julie Rovner's report.

Dec. 5, 2001 -- Every fall, many Americans make choices and changes in their health-care insurance, and this year that also includes Medicare beneficiaries. A 1997 law was supposed to give Medicare's 39 million enrollees more choices for private health plans. NPR's Julie Rovner reports things haven't exactly worked out that way.

Under that law, seniors will be able to change health plans only once next year, unless Congress acts in the next few weeks. Until now, beneficiaries could change every month if they wanted to, but most Medicare beneficiaries don't know they'll soon be locked in. In fact, Rovner finds, most don't know much at all about their Medicare benefits, and lots of them are looking for answers.

With beneficiaries trying to understand programs like Medigap and navigate the differences between an HMO and traditional Medicare, counselors at Medicare rights centers say seniors are more confused than ever.

Advocates for seniors say this is a particulary difficult year to be making such sweeping rules changes, particularly as more private plans drop out of the program or cut back on benefits.

Medicare Resources

For more information on Medicare's open season, how to choose a health plan, and the new lock-in rule, visit:

• Medicare's official consumer site, www.medicare.gov.

• The Medicare Rights Center, www.medicarerights.org, is a New York City-based consumer advocacy organization.

• The Center for Health Care Rights, www.healthcarerights.org, is a Los Angeles-based consumer advocacy organization.

• The Center for Medicare Advocacy, www.medicareadvocacy.org, is a Connecticut-based consumer advocacy organization.

• AARP, a consumer organization for people over age 50, offers extensive information on Medicare health plans.

• Or call 1-800-MEDICARE (633-2273).

In Depth

 Browse for other NPR stories about Medicare.