Our HMO is able to offer us this health plan because of their contract with the government agency that handles Medicare. Under this contract, the government agrees to pay the HMO a fixed monthly amount for each member the HMO serves. The amount the government pay the HMO is based on 95% of the average yearly cost Medicare pays per beneficiary in a specific geographic area.
With this money, the HMO contract with well-established physicians and hospitals to care for HMO members. This means that all my medical services must be provided and arranged by my HMO Primary Care Physician, as long as I am enrolled in the HMO plan. There is no monthly cost and only a small office cost, in my case $6.00, and Emergency Room care is billed at $40.00 per visit if you are not admitted to the hospital. I receive a yearly physical for the office visit fee of $6.00. There are provisions for discount prescriptions, eye exams and glasses, plus discount dental care, all under this HMO contract. Your Medicare is not terminated during your HMO enrollment, as Medicare is dormant and the HMO pays for and schedules your medical care. Most HMO's can provide additional services not covered by Medicare and still save you money for you and Medicare, and I can drop the HMO any time and go back to Medicare.
I have proposed that the government revert to HMO care of all qualified seniors on a nation wide program, doing away with medical care under Medicare. Seniors on a nation wide program, doing away with Medical care under Medicare. Medicare could be converted to a nation wide HMO program within sixty days under a qualifying conversion, which would at the same time purge the Medicare rolls, saving millions of our tax dollars. People that can afford their own health insurance should be purged from the government Medicare rolls, and qualifying citizens under 65 could be covered by this HMO program, purging the Medicade rolls of deadbeats.
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Last change 5/30/96