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    Health Care Reform:

    Health Insurance & Affordable Care Act

    Older Americans are facing a Medicare health care system featuring more options -- and more uncertainty....

    Making the Right Medicare Decision


    Advocates also recommend that seniors ask their friends about theirexperiences. Archer suggests asking those who have had the most healthproblems, because they will know best how a plan functions.

    The American Association of Retired Persons (AARP), the nation's largestmembership organization for older Americans, also offers a variety of bookletsthat can help, from "9 Ways to Get the Most From Your Managed Health CarePlan" to "Medicare Basics," says an AARP spokesman. HCFA provides otherbooklets besides the "Medicare and You 2000" handbook, including a "Worksheetfor Comparing Medicare Health Plans."

    For now, if people are unhappy with their choice, they can leave oneMedicare plan and enroll in another within 30 days. That policy, however,will change in 2002, when only one change will be allowed in the firstsix months of the year. In 2003, only one change will be allowed in thefirst three.

    Rising Costs

    Even with Medicare and the new managed care options, older Americans arefinding health care expenses rising.

    "The biggest problem for most people is affording the health care theyneed, even with Medicare," says Archer. "People are telling us they can'tafford to get the care they need, because Medicare supplemental policiesare too expensive, medications are too expensive, and they are having troublewith special needs if they are in HMOs."

    The average Medicare beneficiary pays 18 percent of his or her annualincome, or about $2,370, for out-of-pocket health care costs -- over $200more than in 1997, says an AARP official. These costs include buying supplementalinsurance, known as Medigap, to pay for deductibles and co-payments notcovered under the original Medicare plan, as well as prescription drugsand services not usually covered under Medicare, such as dental, hearingand vision care.

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