As insurance costs rise, seniors are desperate for help.(Knight Ridder Newspapers)

MIAMI _ With insurance companies announcing this week that Medicare HMO members will face major increases in their out-of-pocket costs next year, desperate seniors are turning for help in ever-increasing numbers to Washington politicians. So are the health plans.

"They've got to do something," complained Manny Kieselstein of Hallandale Beach, Fla., after receiving notice of higher co-payments from Humana. "It's terrible. We're on fixed income. It's hurting us."

Based on this week's announcements Manny and his wife, Irene, are facing the prospect of paying $200 a day for the first five days they're in the hospital. Last year, there was no charge for an in-network hospital. For 2003, they'll continue paying nothing for generics, but for most branded drugs, their co-pay will be $25 to $50, with a maximum benefit of $100 a month. This year, the co-pays are $20 to $40 and the monthly max was $150.

Another popular plan, Blue Cross Blue Shield of Florida's Health Options, has dropped all drug coverage for 2003, after having a $500 semi-annual cap this year.

Facts like that are likely to reverberate around Capitol Hill next year as an even bigger issue than drugs-for-seniors was in the presidential campaign of 2000, when both candidates were promising legislation. The war of terrorism and budget deficits delayed action, but mounting pressure from seniors may force Congress to do something about Medicare after the election.

The health plans want action from Congress as well. The health plans insist Medicare to should provide more money for HMOs, which receive lump sums from the government for each senior member in return for taking care of the senior's health needs.

"We're been limited to a 2 percent reimbursement increase each year," said Pamela Gadinsky of Humana, "while our costs have been going up double-digits."