BlueCross, Kaiser Permanente To Stop Offering Medicare HMO Plans Next Year in Santa Clara, Ventura Counties
BlueCross of California and Kaiser Permanente will stop offering their Medicare+Choice plans beginning Jan. 1, 2004, in limited areas in Ventura and Santa Clara counties, the Los Angeles Times reports. Medicare+Choice plans are private HMOs that typically provide coverage for care that is not fully covered by Medicare. BlueCross and Kaiser officials said low enrollment in Ventura and Santa Clara counties, low federal reimbursements and rising medical costs led to the decision, which will affect more than 7,500 people in the two counties. CMS has approved the companies' decisions (White, Los Angeles Times, 9/24). However, Kaiser officials said the HMO could afford to continue offering coverage to members in eastern areas of Ventura County because they are located near Kaiser clinics in Simi Valley and Thousand Oaks and the HMO's hospital in Woodland Hills, the Ventura County Star reports. Kaiser cannot afford to continue providing coverage to members in the western areas of the county because it cost more to contract with non-Kaiser providers there, according to Kaiser spokesperson Jim Anderson (Wilson, Ventura County Star, 9/24). CMS Administrator Tom Scully said many beneficiaries who are enrolled in the BlueCross or Kaiser Medicare+Choice plans will be able to find new Medicare+Choice coverage through other companies (Los Angeles Times, 9/24). The Star reports that PacifiCare is the only other insurer that provides a Medicare+Choice plan in Ventura County. PacifiCare spokesperson Dan Miller said the company is "more than prepared" to accept beneficiaries who previously had coverage under BlueCross or Kaiser (Wilson, Ventura County Star, 9/24). However, Rep. Lois Capps (D-Calif.) said the change will be "traumatic" for some Medicare beneficiaries. Capps said any beneficiaries who are about to lose coverage should call senior advocacy groups, such as the Ventura County Area Agency on Aging, for advice on how to find other coverage options (Los Angeles Times, 9/24).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.