HMSA to drop Medicare plans for 46,000 seniors

[whalesong]

Hawaii Medical Service Association plans to discontinue its five Medicare Advantage plans for 46,000 seniors on Dec. 31.

The state's largest health insurer, which covers the bulk of Hawaii's Medicare population, estimates it lost about $64.1 million last year on its plans -- called Akamai Advantage -- due to higher-than- expected medical claims as well as lower federal Medicare reimbursements.

The company will begin offering four new higher-premium plans in 2015 ranging from $70 and $126 a month on Oahu and $152 and $195 on the neighbor islands. HMSA currently has five Akamai Advantage plans with premiums ranging from zero to $91 a month.

HMSA said it is not changing its Medicare plans to save money, but to "better reflect the benefit needs and cost of caring for our members."

AlohaCare announced last month that it also is ending its main Medicare Advantage health insurance plan in 2015, a move that will affect 1,300 senior members, after losses of $18.5 million since 2006.
[V]
Declining Medicare reimbursements, which typically do not cover the cost of medical services, have put a strain on health plans both locally and nationally. AlohaCare is paid a flat fee of $8,000 on average per member a year by the Centers for Medicare & Medicaid Services for the Medicare Advantage plan.

UnitedHealthcare and Kaiser Permanente Hawaii said there will be no significant changes to its Medicare Advantage plans. Ohana Health Plan said it will offer just two plans next year.

http://www.staradvertiser.com/news/break...niors.html

[punaticbychoice]

Medicare for all.
Womb to tomb.
End the private health insurance for profit middle-men.
It's about HMSA, so it is Hawaii- along with the rest of the US.
And our dysfunctional "health care system".

[kalakoa]

our dysfunctional "health care system"

Do not make the mistake of equating "insurance" with "health care".

[punaticbychoice]

Absolutely+++++, kalakoa.
Exactly the point!!

[ericlp]

I thought that was the WHOLE IDEA behind the care act? To never deny anyone health care? If you got it, they aren't suppose to drop you no matter what. Seems to me HMSA and AlohaCare might be running into some class action law suits. Tho, I am sure they looked at all their options. Maybe the Fed can get in on it as well?

I think it's wrong. Maybe we should all send these insurance companies a letter and tell them we no longer support them since if they can just drop people from a certain plan that they offered in the past... Maybe it will be you NEXT that they drop because they determined too many shareholders on wall street were losing money. It's just not right.

HMSA estimates it lost about $64.1 million last year on its plans --

HMSA said it is not changing its Medicare plans to save money, but to "better reflect the benefit needs and cost of caring for our members."

Nope, there not doing it to save money. Uh huh... Damn can it be any more obvious?


-------------------------
To email me click on Link http://is.gd/QMfVEX

[mmbvd7]

One thing that has amazed me is how insurance companies have so many requirements that must be met so that a healthcare provider or facility can deliver care. The manpower in the healthcare setting to make sure these requirements are met drives cost to deliver care. It is like a never ending cycle. Then, with health care portability, electronic medical records are required. These systems are very expensive to install in a private setting. So, how are those costs covered? The price of services go up to provide the software, hands on devices, and IT staff. In some cases, providers (at least in other states) will no longer accept Medicaid or Medicare patients because the rate of reimbursement does not cover general running costs in practice. Sorry, off on a rant, but it is frustrating to hear of more cuts to Medicare. UGH.

Best wishes

[lavarat]

These third party insurance plans are bought by persons who want extra protection beyond that offered by the regular Medicare plan, such as paying the annual deductible, 20% of office visits, and prescription drugs. Depending on the person's needs, the extra premiums may be more than what the person would pay without the extra insurance. Like any insurance, you can pay a lot of money for many years and then be dropped without collecting for any claims or collecting very little compared to the premiums paid. Under Medicare for six years, I have rarely paid more than a minimal amount compared to the premiums that I would have paid for extra insurance. That extra money is still in my pocket and I can use it for future needs.

[kalakoa]

I thought that was the WHOLE IDEA behind the care act? To never deny anyone health care?

No. We did not get "universal health care". We got "everyone is required to have insurance". ACA was originally designed to include a "public option" (aka "medicare for everyone"), but this feature was removed at the behest of the insurance company lobbyists.

with health care portability, electronic medical records are required

Unfortunately these requirements are not meaningful; "standards" are mandated rather than "interoperability". Doctors are still faxing paper forms because none of the EMR systems actually work.

Read the requirements carefully to discover the glaring lack of usefulness. Example: your healthcare provider must provide you access to your records, but exactly how this should happen is not defined anywhere. There is no way for individuals to have their own EMR as "data", instead they will print everything on paper.