Miriam Spitz tied a white plastic skeleton and a black balloon to the antenna of her Taurus station wagon, then got ready to roll.
Along with her black clothing, Spitz's unusual car ornaments symbolized the life and death questions facing thousands of Hernando County and Florida residents losing Medicare HMO coverage this year.
Spitz and two dozen seniors met Tuesday in a Target parking lot on U.S. 19 for a mock evacuation to Pasco County, an event that more closely resembled a funeral procession, headlights included.
"I live on insulin, enzymes, blood pressure medication and anti-depressants," said Spitz, a survivor of breast cancer who is in remission for pancreatic cancer. "You can't be too happy knowing you're going to die if no one pays for your medicine."
The protest underscores a burgeoning concern among elderly residents in Florida and around the country as HMOs pull out of areas where they can't turn a profit.
The loss of the last two Medicare HMO companies in Hernando County at year's end will affect 10,000 residents who will lose life-saving prescription drug coverage not offered under traditional Medicare. More than 26,000 Florida residents will be left without Medicare HMOs at the end of this year, while an estimated 900,000 people nationwide will be affected by Medicare HMO withdrawals.
For Spitz, the evacuation was a trial run.
"I'm selling my house," she said, flicking an ash from her cigarette as she waited for the caravan to move. Instead of Pasco County, where HMOs remain, she's moving to Southeast Florida, where Medicare HMOs grant the greatest benefits without charging premiums.
Spitz and the others are not reassured by the applications of two companies, Well Care Health Plan and UnitedHealthcare, to enter Hernando County with a Medicare HMO plan starting Jan. 1. Instead, they want help from Gov. Jeb Bush to get immediate federal relief and long-term changes so companies won't pull out in the future.
Their signs show they need help now.
"How do you spell dead? No HMO," read a sign on a car in front of Spitz, whose plastic white skeleton broke its neck while flapping wildly on the drive south on U.S. 19.
Once across County Line Road, the group pulled into a lot beside a convenience store and camped in the grass along the highway with signs, a pup tent, a sleeping bag, pillows and folding chairs. Several cars stopped on U.S. 19 to watch the action, yards short of the traffic light. But no accidents occurred.
Continuing her gloomy predictions, Spitz sat in a chair holding a sign that said, "This is what HMO refugees will look like 1/1/2001." It was attached to a ghost mask with a black cape around it.
The signs were not an exaggeration to Frank Carpentieri, 45.
On disability, he fired off a list of medical problems: three herniated discs in his back, two in his neck, a tumor on his esophagus and one on his skull. He and his retired mother, Angela, moved from New York to Spring Hill in February to be closer to doctors on nearby State Road 50.
Now he won't be able to afford his and his mother's medical bills without a Medicare HMO.
"Maybe a sinkhole will open and swallow us up, too," he said.
Joyce Denilen, holding a sign, "To Miami _ Get Free HMO," said she and her husband moved from Pinellas Park last December to 5 acres in Hernando County. Without a Medicare HMO, they can't afford their medication and doctor's bills.
"Now we may have to sell my dream home," Denilen said.