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Federal Consumer Information Center Medicare Questions and Federal Consumer Information Center: Medicare - Questions and Answers

Section 2: Other Medicare Health Plans

Q: What is Medicare + Choice?

A: Congress passed a law in 1997 which made many changes in the Medicare program. The law includes a section called Medicare + Choice which, starting in 1999, lets more private insurance companies offer coverage to people with Medicare. If you live in an area with Medicare managed care plans, you may now have choices in how you get your health care.

Q: Will other types of Medicare health plans be available in the future?

A: Medicare Medical Savings Accounts and Private Fee- for- Service plans may be available in the future. At the time this book was printed, no private companies had decided to offer these plans. For more information or to find out if either of these plans have become available in your area, call 1-800-MEDICARE (1-800-633-4227 or TTY/TDD: 1-877-486-2048 for the speech and hearing impaired).

Q: Who can join Medicare managed care plans?

A: To be eligible for Medicare managed care plans:

• You must have both Part A (Hospital Insurance) and Part B (Medical Insurance).

• You must not have End- Stage Renal Disease. (ESRD is permanent kidney failure that requires dialysis or a transplant.) However, ESRD beneficiaries currently in a health plan will be able to remain in the plan they are in.

• You must live in the service area of a health plan. The service area is the geographic area where the plan accepts enrollees. For plans that require you to use their doctors and hospitals, it is also the area where services are provided.

Q: Do I have to change to a Medicare managed care plan?

A: If you are happy with the way you receive your Medicare benefits, you don’t have to do anything. You will continue to receive Medicare benefits the same way that you do now. Whether you are in the Original Medicare Plan or a Medicare managed care plan, you are still in the Medicare program.

Q: How do I get information on the Medicare health plans available in my area?

A: You can ask for information on Medicare health plans available in your area by calling 1-800-MEDICARE (1-800-633-4227 or TTY/TDD: 1-877-486-2048 for the speech and hearing impaired). You can get up-to-date information about Medicare on the Internet at www.medicare.gov. Your local library or senior center may be able to help you find this information on their computers. The State Health Insurance Assistance Program* in your area can also help you with Medicare questions about health plan decisions.

Q: If I want to make a change in my health plan, are there other things that I should consider?

A: If you or your spouse has health care coverage that supplements Medicare, check the information provided by your former employer or union, or contact them before you choose a new plan. If you have Medigap coverage, check the information provided by your Medigap insurance company, or call the State Health Insurance Assistance Program* in your State. If you have Medicaid coverage, do not make changes until you call the State Medical Assistance Office*.

* You can find phone numbers for your area in your copy of Medicare & You or on the Internet at www.medicare.gov under Important Contacts.

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