There are a number of ways people are lured into signing up for Health Maintenance Organizations or HMOs. The best method so far is advertising or rather misleading advertising, in which HMOs appear to offer more than they actually deliver. I think this is one of the reasons why organizations like the Health Administration Responsibility Project exist.
One indicator of such misleading marketing tactics is when the offered plan is just too good to be true. And because of the implementation of ‘lock-in’ rule, wherein beneficiaries are not allowed to switch plans; all the more that this misleading advertising poses a great threat to the public than ever before.
Here are some marketing tactics HMOs use to lure beneficiaries to sign up for coverage:
- Unlimited prescription drug coverage. Consumers must be warned about this unlimited generic and brand name prescription drug coverage offer by several HMOs. The ‘unlimited’ catch is misleading since most HMOs cover only medications listed on a formulary or preferred drug lists.
- Better than Original Medicare. Some medical plans are actually offering more benefits than Medicare but they are not really for free. They come at a cost.
- $0 Premium offer. Plans often boast of a $0 premium while in fact individuals are required to pay their Medicare Part B premiums, done monthly at $78.20.
There are I guess a lot more, but the point here is that beneficiaries should really be on-guard against these marketing tactics. A nationwide list of healthcare specialist attorneys is available for those who might need some assistance in this particular issue.
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December 15th, 2008 at 2:52 pm
We deal with individuals being “ripped off” by their monthly HMO fee’s all the time. It is important to ask questions and run the numbers yourself
March 5th, 2009 at 12:30 pm
In the past two years alone, Medicare HMOs have dumped 75O,000 seniors who proved unprofitable. HMOs have recruited seniors by routinely misleading them about benefits. This year, Medicare HMOs are dramatically scaling back the prescription drug coverage that lured many seniors into HMOs in the first place. A four-year study of quality of care by John Ware, published in the October 2,1996, issue of the Journal of the American Medical Association, found that seniors were more likely to decline in health under HMO care than in the traditional Medicare program. Yet, instead of recognizing the failures of Medicare privatization, the Heritage Foundation and its allies in Congress push on.
While traditional Medicaid is a program of uneven quality, with large variations by state, the record of for-profit HMOs in treating Medicaid patients has clearly been worse. Florida officials banned twenty-one of the state’s twenty-nine Medicaid HMOs from expanding enrollment several years ago after systematic abuse of patients was uncovered not by state auditors but by courageous investigative reporters at a local newspaper. These HMOs used fraudulent marketing tactics (for instance, telling patients they would lose their Medicaid if they didn’t enroll), delivered poor-quality care, disenrolled sick patients, and spent up to 70 percent of program costs on overhead and profits.
April 15th, 2009 at 7:19 am
Who is to promote the privatization of medical insurance?
April 20th, 2009 at 4:06 am
May I ask also Who is to promote the privatization of medical insurance?
Waiting for the answer. Thanks.
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December 6th, 2009 at 2:08 pm
My dad’s in the allied health field, and he has been dealing with HMO BS for WAY too long. Its actually the reason why I decided to not become a doctor (that, and organic chemistry…)
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Whether HMOs should be liable for medical injury is a contentious and complex issue. Advocates of expanded liability hold that gatekeeping, precertification, utilization review and many other managed care practices constitute treatment decisions.
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