Among the hardest

hit are seniors in California (84,000), Florida (59,000), Pennsylvania

(55,000), New Jersey (53,000), Texas (46,000), and Michigan (31,000),

who will be losing coverage in the coming year.

Even those

with continuing coverage face substantial premium hikes and dwindling

drug benefits. Particularly hard hit will be those with chronic illnesses

such as respiratory disease, who will bear the brunt of high medication

and healthcare costs.

Though all

seniors 65 and older are covered by Medicare, those enrolled in managed-care

programs agree to see doctors within a limited network and receive additional

benefits, such as preventative care and prescription-drug coverage. The

current coverage crisis stems from rising delivery costs and limited government

reimbursement, as doctors and hospitals increasingly balk at seeing Medicare

HMO patients, since they aren't sufficiently reimbursed for their services.

Without enough

doctors and hospitals providing care, an HMO can't serve its members.

The problem is worst in large urban markets, where more than half of Medicare

+ Choice beneficiaries live nationwide but where reimbursement rate increases

have trailed rising costs since 1997.

To compensate

for the funding shortfall, premiums for seniors retaining Medicare HMO

coverage are expected to spike while benefits dwindle in the coming year.

In California's Sacramento-area, for example, monthly premiums for Kaiser

Permanente's Senior Advantage Medicare Plan will double from $40 to $80

starting Jan. 1.

Healthnet,

following suit, is raising premiums 50 percent, from $40 to $60 per month

for its Seniority Plus members in the area. Pacificare and Western Health

Advantage, while holding monthly premiums at $50 in their Sacramento-area

Medicare plans, will eliminate brand name drug coverage next year.

Across the

nation, seniors caught between rising premiums and shrinking coverage

will find themselves in a similar bind. Even those with Medigap policies

will feel the squeeze.

Medigap policies

A through J, for instance, have minimum standard benefit packages, and

the H, I, and J plans covering prescriptions have annual drug caps ranging

from $1,250 to $2,000.

For the 30

million Americans with a chronic obstruction pulmonary disease such as

asthma, emphysema or cystic fibrosis, however, help is available with

Geriatric Services of America (GSA), a national community service organization

based in Tempe, Arizona which provides direct help and support to older

Americans suffering from chronic respiratory disease.

Through its

Respiratory Disease Control Program, GSA provides access to a comprehensive

range of special medication benefits, as well as support and homecare

services, which eliminates out-of-pocket expenses for patients with primary

or supplemental insurance coverage.

Through GSA's

patient support center, nebulizers and respiratory medication are provided

and paid for with free home delivery, conveniently packaged and ready

to use. GSA handles all paperwork, and clinical Patient Care Coordinators

work with doctors and insurance companies once a patient has enrolled

in the Respiratory Disease Control Program. Patients can enroll themselves

in the program; there is nothing to buy, and no enrollment or membership

fees.

Currently,

Medicare, AARP, Blue Cross, Blue Shield, and over 180 other insurers have

special benefits for patients with respiratory disease. GSA provides access

to these benefits, and coordinates all elements of care to help patients,

doctors, and insurance companies combat respiratory disease.

At a time when

seniors face restricted health care access, rising premiums, and shrinking

benefits, GSA stands out as a welcome ally for those needing respiratory

medication benefits, support, or homecare services. For more information

about GSA, or how someone you know can enroll in this special wellcare

program, write to 4812 South Mill Ave., Tempe, AZ 85282; call 800-307-8048;

fax 800-345-2425; or email Gary Rheault directly at [email protected] .

Del Williams is a technical writer based in Torrance,

California.

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