3 congressmen hear elderly on Medicare HMO exodus Waxter assembly told prescription coverage is primary concern

Health insurance

October 27, 1998|By M. William Salganik | M. William Salganik,SUN STAFF

Three congressmen whose districts include parts of Baltimore met yesterday with about 75 senior citizens who voiced concerns about Medicare HMO pullouts.

Seniors are worried primarily about finding a plan that would cover the costs of prescriptions, said Jean Booker Bradley, chairwoman of the health committee for the Historic East Baltimore Community Action Coalition (HEBCAC).

"We need some help," she added.

Medicare HMOs have been offering a prescription benefit, but four are pulling out of the market or limiting coverage effective Jan. 1, leaving about 35,000 Maryland seniors looking for new health plans.

Rep. Benjamin L. Cardin, a Democrat representing the 3rd District, told the seniors that they have the option of joining a different Medicare HMO -- four are still offered in Baltimore -- or to return to traditional Medicare, perhaps with a "Medigap" supplemental policy.

He advised them that each case is different, and that it was important to discuss the options with their physicians and with counselors from state or local agencies for the aging.

"You could be bombarded with brochures from HMOs," Cardin said. "You may get called by people who want to sell you a Medigap policy. But make sure you talk to someone who doesn't have a financial interest in what you decide."

Cardin is conducting more than a dozen meetings throughout his district. He was joined yesterday by Reps. Wayne T. Gilchrest, a 1st District Republican, and Elijah E. Cummings, a 7th District Democrat, for a session at the Waxter Senior Center, which draws seniors from throughout the city.

Michael LaChance, from the state senior Health Insurance Counseling and Advocacy Program, and Germano Gomez, coordinator for the city's insurance counseling program, also attended the session to provide advice. Each county has a similar program.

About a third of those in attendance said they are in HMOs. But even those who were not came with questions, particularly about how to get prescription coverage and about services available at health clinics.

Cardin said he thought the federal government needed to find a way to extend coverage for prescription drugs, which he called "essential for medical care."

The basic Medicare coverage does not pay for prescriptions, so seniors can get the benefit only by joining an HMO or buying a Medigap policy.

Pub Date: 10/27/98

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