New “Lock-In” law threatens older and disabled Americans’ access to health care...Timely disenrollment from Medicare HMOs has been a life saver that Congress must restore, consumer group reports  

New York, NY – Beginning this weekend, older and disabled Americans who are enrolled in a Medicare private health plan will be required by law to stay in their plan until the end of the calendar year.  In 2007 and beyond, they will be locked into plans beginning April 1. 

“People with Medicare will be trapped in private health plans that are hazardous to their health if Congress does not lift the ‘lock-in’ law,” said Robert M. Hayes, president of the Medicare Rights Center.  “Getting out of Medicare HMOs and back to Original Medicare has often been the remedy for people who hit road blocks when they needed health care, or discovered they had large, unexpected costs when they got sick.”

People with Medicare will be locked into their health plan regardless of whether the plan meets their health care needs or they can afford the plan’s out-of-pocket costs, reports the Medicare Rights Center, a national consumer service organization.  People victimized by high-pressure marketing techniques and misinformed about managed care restrictions will also be locked into their plans.

Using numerous case examples, the Medicare Rights Center’s report, Elimination of Plan Lock-In: A Vital Consumer Protection, illustrates how disenrollment from a Medicare HMO and return to Original Medicare preserves consumer choice of doctors and hospitals, and has been an essential counter-measure to inappropriate marketing, unexpected high cost-sharing, health plan network restrictions, and unjustified denials of coverage for care.

“People duped into joining HMOs by savvy marketing representatives should not have to suffer the consequences of being locked into the wrong health plan,” said Mr. Hayes.

The Medicare Rights Center reports that about 25 percent of the Medicare HMO cases it has handled between January 2004 and June 2006 involved denials of medical care by HMOs, with durable medical equipment, diagnostic services and emergency care comprising the majority of denials.  Less than 9 percent of people in Original Medicare called about a denial in the same period.  About 5 percent of the HMO callers expressed an intention to disenroll from their plan.

About 12 percent of people with Medicare are enrolled in private health plans, primarily HMOs, according to the Kaiser Family Foundation.    

The Medicare Rights Center’s report Elimination of Plan Lock-In: A Vital Consumer Protection is available at  http://www.medicarerights.org/lockin_0606.pdf .

Medicare Rights Center (MRC) is the largest independent source of Medicare information and assistance in the United States.  Founded in 1989, MRC helps older adults and people with disabilities get high-quality, affordable health care.