"Don't Fall for the Hard Sell" is the very appropriate title for an article in AARP's October 2007, Bulletin.

This article discusses the pitfalls associated with the federal government's efforts to privatize the Medicare program by contracting with commercial insurance companies to administer benefits.The program is called Medicare Advantage.

Any senior citizen who has been approached by one of these insurance companies and who may be considering a switch from regular Medicare to Medicare Advantage should read this article carefully. Anyone considering such a change should research the facts thoroughly and not rely on an insurance company sales person to interpret them for you. Keep in mind they are receiving a commission to sell a product.

The Medicare program has a very informative website at www. medicare.gov that can be used to explain Medicare Advantage in more detail and compare products. For those without access to a computer, someone in administration at Wills Memorial Hospital will be glad to help.

Some important facts that should be understood about Medicare Advantage are these:

1. If you sign up for Medicare Advantage, you are giving up your regular Medicare.

2. You can return to regular Medicare, but only once per year during an open enrollment period, November 15 through December 31.

3. If you sign up for Medicare Advantage, any supplemental policy you may have becomes invalid.

4. Many of the Medicare Advantage products carry significantdaily copays and deductibles that must be paid out-of-pocket since you may not carry a supplemental policy under Medicare Advantage.

5. Depending on the product, you may be required to see only certain doctors or go to certain hospitals.

6. Depending on the product, you may be required to see only certain doctors or go to certain hospitals.

6. Depending on the product, a hospital or doctor has the right to refuse non-emergency service if they are not in agreement with the terms and conditions of the insurance company.

7. Some Medicare Advantage products carry monthly premiums that are in excess of regular Medicare monthly premiums.

8. Because of past abusive sales tactics by some insurance company representatives, no Medicare Advantage sales person is allowed to come uninvited to a person's home.

The important message is to do your homework and choose wisely if you are considering leaving regular Medicare for a Medicare Advantage product.

It is also important for the community to understand the potential impact the Medicare Advantage program may have on Wills Memorial Hospital, and every other small rural Critical Access Hospital in the country.

The Critical Access Hospital (CAH) program was created by federal legislation in the late 1990s. This program essentially created a financial "safety net" for small rural hospitals by requiring Medicare to reimburse CAH hospitals for all allowable costs they incur in treating Medicare patients. Under the Medicare Advantage program, insurance companies are not required to pay on this same basis. In most cases, they can pay us whatever they want to, and if we accept the patient, we must agree to accept their payment, whatever it may be.

If the hospital is paid an unsatisfactory rate, our only option is to no longer accept patients with coverage by that particular company. The Medicare Advantage program has the very real potential of undermining the CAH program and placing our financial stability at risk.

The notion of privatizing the administration of Medicare benefits was conceived as a way to save the Medicare program money. Ironically, the Congressional Budget Officehas recently determined it has done just the opposite and is costing more than conventional Medicare.

The real winners -- the insurance companies!