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What is Medicare+Choice?

Medicare+Choice is a health plan alternative such as a Health Maintenance Organization (HMO) that is offered by a private company approved by the Centers for Medicare and Medicaid Services (CMS). The plan is to enhance your current health care benefit package by providing you with additional services that can include additional costs.

Where did it come from?

Medicare originated in 1965 as a supplement to health care benefits under Social Security and not designed to cover 100 percent of all of our medical bills; it was designed to help older, retired or disabled Americans to receive health care benefits without financial burden. In 1997 the Balanced Budget Act called for alternatives to the original Medicare plan. The Centers for Medicare and Medicaid Services (CMS), formerly known as the Health Care Financing Administration (HCFA), created and administers all Medicare options, including the new “Medicare+Choice”.

Why is it important to me?

It provides options to your health plan needs.

What are the costs?

Costs are the Part B Premiums (currently $58.70 per month), and the plan’s premium.

What are my options?

• Original Medicare
• Original Medicare and a Medigap Policy
• Original Medicare and another insurance supplement
• Medicare+Choice

How will I benefit?

Medicare+Choice plans offer Enhanced Benefit Packages, limited out-of-pocket expenses; no waiting for reimbursement, and it allows you to budget for health care expenses with preset co-payments for health care services.

Who do I call for more information?

Hawaii’s State Health Insurance Assistance Program (Sage PLUS) at (808) 586-7299 (Oahu) or 1-888-875-9229 (Neighbor Islands). Ask for the easy-to-understand booklet titled “Medicare+Choice in Hawaii 2001”.

How do I know if I am eligible?

If you are currently a Medicare Beneficiary you are eligible or you can call the Social Security Administration at 1-800-772-1213.

Things to remember:

• I don’t have to switch from my current health care plan.
• Medicare+Choice is often referred to as Medicare Part C.
• I must pay for Medicare Part B premiums to be eligible for Medicare+Choice.
• Not every community has all choices available.
• Like any HMO, I am limited to the provider network of services, doctors and hospitals.
• Not every health care provider accepts Medicare+Choice.

Test My Knowledge of Medicare+Choice

Funding is provided by the U.S. Department of Health and Human Services, The Centers for Medicare and Medicaid Services, and the Administration on Aging. It was designed and is being provided by the State of Hawaii Executive Office on Aging to provide information to those eligible to receive Medicare benefits and to inform them of alternatives that can enhance their current benefits.