Subject(s)
Managed Care Programs/legislation & jurisprudence , Medicare Part C , Continuity of Patient Care , Humans , Insurance Benefits/economics , Insurance Benefits/legislation & jurisprudence , Insurance Benefits/statistics & numerical data , Legislation, Medical , Managed Care Programs/statistics & numerical data , Medicare Part C/legislation & jurisprudence , Medicare Part C/statistics & numerical data , Patient Education as Topic , Time Factors , United StatesABSTRACT
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.