PacifiCare Lowers Medicare HMO Cancer Treatment Copays

PacifiCare's Secure Horizons Medicare+Choice plan, one of the nation's largest Medicare HMOs, announced yesterday that it will lower copayments for cancer treatment, following "widespread complaints" from cancer patients, some of whom paid "hundreds, even thousands" of dollars a month for treatment, USA Today reports. In January, Secure Horizons began charging copayments as high as $550 for some chemotherapy drugs and as high as $250 for radiation treatment. The managed care company said such fees were necessary to offset low Medicare reimbursements. However, critics of the increases said that the higher copayments were "driving some patients from needed care." In response, PacifiCare developed a new plan in which some cancer drugs and radiation treatments will have no copayment, while other treatments will have copays between $10 and $200, depending on the cost of the treatment. According to PacifiCare officials, approximately 75% of Secure Horizons beneficiaries receiving cancer treatment will pay lower fees. Kathy Feeny of Secure Horizons said that the plan was designed to ensure that "no patient will pay more than 20% of the cost of the drug or treatment." Still, USA Today reports that many patients taking newer cancer treatments will still be forced to pay high copays. For example, Secure Horizon beneficiaries in Texas will pay a $150 copayment for the "most expensive cancer drugs," including the breast cancer drug Taxol and the prostate cancer treatment Lupron (Appleby, USA Today, 4/4).