Medicare HMO Lock-In Is Scheduled to Take Effect July 1

Last Updated: 5/31/2006

After June 30, 2006, seniors enrolled in a Medicare managed care, such as an HMO, will not be able to switch plans or move to original Medicare during the year. The lock-in has been postponed twice, but starting July 1, 2006, managed care enrollees will be able to change plans only once a year between November 15 and December 31. Previously, enrollees in Medicare managed care plans, also called Medicare Advantage, have been able to switch plans whenever they wanted to.

The lock-in means managed care participants will be unable to change plans even if their doctor leaves the provider network or a network hospital doesn’t offer the specialty care they need. According to an article in the Cleveland Plain Dealer, there are several bills in Congress that would remove or postpone the lock-in, but the Bush administration is opposed to any changes.

For the Plain Dealer article, click here.

How good a deal are Medicare Advantage plans? A recent study by the Commonwealth Fund concludes that they may not always be better than regular Medicare for sicker beneficiaries who use more health services. For details, click here.

For more information on Medicare managed care, click here.