Should Medicare HMO Benefits Be Standardized?
Open Access
- 1 July 1999
- journal article
- Published by Health Affairs (Project Hope) in Health Affairs
- Vol. 18 (4) , 40-52
- https://doi.org/10.1377/hlthaff.18.4.40
Abstract
Legislation enacted in 1990 standardized Medigap benefits but not the benefits of health maintenance organizations (HMOs) that serve Medicare beneficiaries. An examination of marketing materials in two large counties reveals the potential for enormous confusion among beneficiaries because of differences in wording to describe the same benefit, health plans' failure to list Medicare-covered services, and the differences in the benefits themselves. To date, the Health Care Financing Administration (HCFA) has not been able to overcome this confusion through the comparative material distributed on its Web site; indeed, significant errors were found, reflecting to some extent the underlying difficulties in characterizing benefits. Ways of ameliorating the situation are discussed.Keywords
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