Joining HMO poses dilemma



KNIGHT RIDDER NEWSPAPERS
Q. I need help with my pharmacy bills and would like to sign up for a Medicare prescription drug plan. Do I have to enroll in a Medicare HMO to get the new prescription drug benefit? I've had the same doctor for years and worry that I'd have to switch if I join an HMO. --Maxine
A. You can join a Medicare HMO to get all of your benefits -- including prescription drugs, but you can also stay in traditional Medicare and keep the same doctors you now have, if that's what you prefer. If you stay in traditional Medicare and want prescription drug coverage, you will need to enroll in a separate Medicare-approved prescription drug plan.
There will be many such drug plans offered throughout the country in 2006, and you can enroll anytime between Nov. 15 and May 15. Medicare is sending out a handbook that includes a list of plans that will be offered in your area. Your next challenge will be selecting the plan that is best for you.
Since you've made up your mind about keeping your doctor and staying in the traditional Medicare program, look for plans that cover prescription drugs only, rather than HMOs or PPOs that cover all Medicare benefits (called Medicare Advantage plans). Beyond that decision, there are likely to be important differences among the Medicare drug plans offered in your area. Check to see which plans cover most, if not all, of the drugs that you take, compare prices and look for a plan that allows you to use a convenient pharmacy. Also consider mail order as an option to lower your costs.
The good news is, once you've made your decision for 2006, you won't have to think about these decisions again until late next year during the open enrollment period.
You can find out more about your options, research specific plans in your area and sign up for most plans on Medicare's Web site at www.Medicare.gov or by calling (800) MEDICARE.
XThis column was prepared by the Kaiser Family Foundation, an independent, nonprofit private foundation based in Menlo Park, Calif., not affiliated with the Kaiser Permanente health plan. Send questions about the new Medicare drug benefit to Medicare Q & amp; A, The Kaiser Family Foundation, 1330 G St. NW, Washington, D.C. 20005 or MedicareQ@kff.org.