1.   As premiums rise, healthy seniors drop their medigap coverage, leaving behind sicker seniors with costlier medical bills.

2.   But HMOs tend to attract relatively healthy seniors, leaving medigap insurers with sicker and more costly patients.

3.   But some healthy seniors also get their nails trimmed by podiatrists who then improperly bill Medicare.

4.   Dallek also said that as healthy seniors switch to health maintenance organizations, those who keep traditional coverage tend to have more costly illnesses covered by the Medigap policies.

5.   Eventually, however, even healthy seniors will age and encounter health problems.

6.   Especially in short supply are rentals for healthy seniors who can live in independent residences.

7.   He said HMOs are recruiting healthy seniors and getting overpaid by Medicare to care for them.

8.   Opponents say the concept is flawed because the MSA will be used only by healthy seniors who expect to reap a windfall from low out-of-pocket expenses.