Medicare+Choice Plans Drop Markets, Benefits, Raise Rates
As reported yesterday California Healthline, Medicare HMOs across the country are changing benefits packages, increasing their premiums or exiting the federal program altogether. Companies had a Sept. 17th deadline to inform the Centers for Medicare and Medicaid Services of their plans. While CMS has not yet released a comprehensive listing of changes, announcements continue to come in from several states.
- Illinois: United HealthCare of Illinois has opted to drop its Medicare HMO in Cook County, which will impact more than 33,000 seniors, the Chicago Tribune reports. In making its decision, United cited low reimbursements and federal regulations that "handicap" plans in certain areas of the country. United had eliminated its drug benefit on Jan. 1, which resulted in an enrollment drop of 25%. With the HMO's exit, the Chicago area will have one Medicare HMO, Humana Inc. While Humana will continue operations, it has not announced if it will change its benefit packages (Japsen, Chicago Tribune, 9/19).
- Kentucky: While it will continue operations in Chicago, Humana Inc. is dropping its Medicare+Choice plan in Kentucky and Southern Indiana, Business First of Louisville reports. According to Humana, its decision will affect about 14,000 seniors, who will need to revert to traditional Medicare or find new HMO coverage. Due to low reimbursements, Humana said it has stopped offering Medicare HMO coverage in 45 counties overall (Business First of Louisville, 9/17).
- Louisiana: Seniors enrolled in Medicare+Choice plans in Louisiana have some "good news and bad news," as the three plans in the state will continue providing coverage next year but will increase costs and reduce benefits, the Baton Rouge Advocate reports. Ochsner Health Plan's "Total Health 65" HMO, the state's largest HMO, plans to limit new customers to 200 per month, will increase "some" of its copayments and is dropping drug coverage for members in Baton Rouge, Livingston and Iberville. George Renaudin, Ochsner's senior vice president of administration, said, "We're pleased we're not doing any withdrawals this year. It's been a real juggling act to stay in the Baton Rouge market. We were pretty proud we could stay." The Oath, an HMO that offers a product called SmartPlan 65, is raising copayments and will charge a $70 monthly premium. Since 1999, Medicare HMOs have been "scaling back" products or exiting Louisiana completely, the Advocate reports (Gautreau, Baton Rouge Advocate, 9/19).
- Texas: Texas Health Choice has announced it will drop its Medicare product in the Dallas-Fort Worth area because of low reimbursements, the Dallas Morning News reports. With this withdrawal, Tarrant County will have one Medicare+Choice plan remaining, AmCare Health Plans of Texas. Texas Health Choice will immediately stop accepting new members (Solis, Dallas Morning News, 9/19). Members of Texas Health Choice's HMO, called Golden Choice, will retain their coverage until Dec. 31. Unless they switch to the other HMOs, they will "automatically revert" to traditional Medicare next year. AmCare has said it will offer its HMO next year, but PacifiCare has said it will announce the "status" of its HMO, Secure Horizons, this Friday (Banstetter, Ft. Worth Star-Telegram, 9/19).
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