MEDICARE HMOs: Pullout Leaves Seniors Little Choice
The announcement that Merced County's lone Medicare HMO is pulling out of the area -- forcing nearly 11,000 seniors to search for new coverage -- is the latest example of a familiar scene unfolding nationwide, the Los Angeles Times reports. With health plans pulling out of the Medicare+Choice program "in droves," Merced County seniors will join nearly 933,000 Medicare recipients nationwide who will be forced to find a new insurer at the end of the year. Although most beneficiaries will switch to other HMOs, about 150,000, such as those in Merced County, will have no other local Medicare HMO option. Rural areas, like Merced County, are shouldering the brunt of the pullout, as HMOs argue that plans serving smaller populations cannot cover themselves financially. Not all experts agree with the industry claim. Marilyn Moon, a senior research fellow at the Urban Institute, said, "There is little evidence, except from the industry itself, to suggest that these HMOs are being underpaid." Finding a solution to the Medicare HMO exodus is particularly critical in California, where 40% of Medicare beneficiaries are insured through HMOs, compared to just 16% nationally (Rosenblatt, 8/14).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.