A few years ago, the federal government unveiled a “Medicare+Choice” program with great fanfare. In addition to traditional Medicare, participants could choose among health maintenance organizations (HMOs), preferred provider organizations (PPOs), medical savings accounts (MSAs), etc.
So far, though, no Medicare MSAs and few Medicare PPOs have appeared. Medicare HMOs are available but they have dropped 2.4 million seniors since 1998. Some of those who were dropped have found other HMOs but the total number of enrollees has declined from 6 million to 5 million, out of the 40 million Americans covered by Medicare.
Enrolling in a Medicare HMO is often a less expensive choice. However, Medicare HMO enrollees lack provider choice and must go through a gatekeeper system. In addition, there are no guarantees that an HMO will stay in the Medicare program from one year to the next.
Even if an HMO does stay in the Medicare program, there’s no certainty the costs and services will remain the same. At the end of 2002, for example, 215,000 enrollees lost coverage because their HMOs dropped out of Medicare; among the remaining Medicare HMOs, some trimmed benefits and raised costs. Unless there’s a financial problem you’re probably better off signing up for traditional Medicare.