Medicare+Choice Withdrawals Hit California Seniors ‘Especially Hard’ This Year

About 88,000 California seniors -- including more than 28,000 in the Bay Area -- will lose Medicare+Choice coverage next year, and many others enrolled in Medicare HMOs will face increased premiums and "dramatic" reductions in benefits, the San Francisco Chronicle reports. Medicare+Choice withdrawals have "hit California especially hard" this year, the Chronicle reports. PacifiCare will drop Medicare+Choice coverage for more than 40,000 California residents in 2002, and Health Net of California plans to drop coverage for about 13,500 seniors. In addition, a number of health plans that will offer Medicare+Choice coverage next year plan to "more than double" premiums and reduce prescription drug benefits. Kaiser Permanente, for example, will raise monthly premiums for Senior Advantage, the health plan's Medicare HMO, from $30 to $40 per month to $80 per month and reduce the cap on prescription drug coverage from $1,600 per year to $1,000 per year. Senior Advantage members also will have to pay a new $50 charge for emergency room visits and ambulance services. Health Net will raise premiums from $30 to $50 per month to $85 per month for seniors in central Bay Area counties and eliminate prescription drug coverage in Alameda, San Francisco and Contra Costa counties. Insurers say the decision to withdraw from Medicare+Choice was prompted by low reimbursement rates from the federal government, which has "put the squeeze" on payments since Congress passed the 1997 Balanced Budget Act. The Chronicle reports that the "historic dominance" of managed care in California has "exacerbated the situation because of the large number of Medicare patients" -- about 40% of California seniors -- enrolled in Medicare+Choice plans, compared with about 15% nationwide. Although seniors who are dropped from Medicare+Choice can still receive health coverage through traditional Medicare, the fee-for-service program does not offer prescription drug coverage and "is simply not affordable" for some seniors (Colliver, San Francisco Chronicle, 11/11).