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Clock is ticking on special enrollment period for Medigap plans

Older and disabled Americans who want to drop their Medicare HMOs to return to traditional Medicare have a limited time to buy Medigap insurance plans that will cover their pre-existing conditions without any waiting periods.

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Medigap insurance plans

Medigap insurance plans are private health insurance policies that supplement traditional fee-for-service Medicare. The federal government has authorized 10 standardized Medigap policies: Plans A through J. Depending on where you live, all 10 of these standard policies — or only a few — may be offered. If an insurance company wants to sell Medigap policies, it must sell at least Plan A. Read The 10 standardized Medigap plans.

Time is running out on this "special enrollment period," which entitles eligible Medicare beneficiaries to switch from their Medicare+Choice HMOs back to traditional Medicare and to buy supplemental insurance policies that will cover their pre-existing conditions without any waiting period. Consumers may purchase Medigap plans at any time during the year, but ordinarily they may have to sit out waiting periods if they have pre-existing conditions.

To be eligible for this special enrollment, beneficiaries must disenroll from their current health plans no later than Dec. 31, 2001, and purchase a Medigap plan by March 4, 2002. Under the special enrollment period, eligible beneficiaries have the right to buy Medigap plans A, B, C or F.

"We are hearing from clients who are now saying that [traditional] Medicare in combination with a Medigap policy provides better value to them than an HMO," says Diane Archer, president of the Medicare Rights Center (MRC). "With Medicare HMOs cutting benefits, increasing premiums, and passing more costs on to older and disabled individuals, [consumers] are less willing to accept HMO limits on choice of doctors and where and when they get their care."

Many older and disabled Americans have no choice. More than 500,000 Medicare beneficiaries are being involuntarily dropped from their Medicare HMO plans on Dec. 31, 2001. This will bring the total number of beneficiaries who lost their plans during the past three years to more than 1.7 million, as health insurers exit unprofitable markets.

The Centers for Medicare and Medicaid Services (CMS) has introduced Medicare's Personal Plan Finder, an online tool that can help you narrow down your Medicare health plan choices and choose a plan that's best for you. You're asked several questions and provided with health plan information specific to the region in which you live and your personal situation.

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