MEDICARE MISINFORMATION IS CONFUSING

It is confusing enough that a new Medicare law which took effect Jan. 1 has some new rules and regulations. But it is simply terrible that an advocacy group is stirring up Medicare recipients by exaggerating or misrepresenting the impact of those new rules on elderly patients in need of health care.

The two main points involved in the dispute are whether or not Medicare recipients can also pay out of their own pockets for treatment that isn't covered by the federal health-care plan, and whether or not doctors can accept direct payments from Medicare patients rather than filing a claim for treatment covered by Medicare.

A group called the United Seniors Association has sent millions of letters to elderly Americans with what appears to be incorrect information, perhaps intended to stir up emotions and to initiate a telephone and letter-writing campaign. To the extent that senior citizens are up in arms, the United Seniors Association effort seems to be working. Newspapers (including the Southeast Missourian) are getting letters to the editor based on the faulty information. Congressional offices are being flooded with phone calls and letters from worried Medicare recipients.

There is no question that Medicare, like most all federal programs, exists within a framework of regulations that are difficult to understand at times. The labyrinth of rules and exceptions to the rules is so complex that some doctors -- estimated at fewer than 4 percent of all physicians -- refuse to participate in the Medicare program. They do not accept Medicare reimbursements and require their patients, including the elderly, to pay for their service.

Under the new law, only these doctors who don't participate in Medicare are permitted to accept direct payments from patients for services covered by Medicare. But since nearly every doctor in America participates in Medicare, the number of affected patients is very low. By and large, Medicare patients are already under the care of participating doctors and do not need to worry about the new rules.

Some elderly patients who are just now qualifying for Medicare complain that they cannot find doctors who will accept them as patients. But this is a decision any doctor makes based on the number of patients that can be handled by any given doctor or clinic. Most doctors set similar limitations on younger patients as well.

Confusion comes when patients can't find a doctor and are also hearing, through inaccurate mailings, that they can't pay for medical attention out of their own pockets.

For the best information, elderly Americans who are concerned about their Medicare coverage should talk to their own physician or the doctor's office staff. Information also may be obtained from the Health Care Financing Administration, the government agency that administers Medicare. HCFA's Region 7 office is in Kansas City, and the telephone number is (816) 426-2866.