Seniors still have
options over next several weeks if they find new plans too limited.
By Christopher Snowbeck Star Tribune
JANUARY 22, 2019 — 10:31PM
Large
numbers of Medicare beneficiaries facing a big shift in coverage for 2019 moved
to Medicare Advantage health plans, apparently drawn to their low premiums and
steered there by insurers.
But
it’s left some wondering if more switching could be coming over the next few
months, as patients start using coverage that can feature tighter access to
doctors and hospitals.
“We
don’t know what we’re going to see in January, February and March when people
start wanting to go to the doctor,” said Kelli Jo Greiner of the Minnesota
Board on Aging. “If they find out their provider doesn’t participate … they may
want to change plans.”
Federal
law forced an unusually large number of Medicare beneficiaries in Minnesota to
switch coverage going into 2019 as the government eliminated a popular form of
coverage called Medicare Cost plans.
Those
plans were eliminated in 66 counties in the state where there’s significant
competition from Medicare Advantage (MA) insurers. It drove a 330,000-person
decline in that sort of coverage between December and January, according to
data released last week by the federal Centers for Medicare and Medicaid Services.
During the same period, MA enrollment grew by more than 200,000 people.
The
elimination of Cost plans set up a choice for consumers: Go with an MA plan
from a private insurer or revert to the government’s original Medicare program.
The
shift also set off a marketing frenzy as insurance companies pushed not only
their MA plans but also Medicare Supplement policies known as “Medigap” plans
and stand-alone “Part D” prescription drug coverage, both of which are popular
among people with original Medicare.
Insurance
agents say the enrollment numbers released last week show many consumers
responded to lower premiums with MA plans.
“A
lot of households couldn’t afford the supplements — they either couldn’t afford
them or they wouldn’t,” said Tom Peterson, an insurance agent with Twin Cities
Underwriters in Roseville.
Another
factor is that health insurance companies that sell Medicare Cost plans were
allowed to steer many beneficiaries to MA plans, said Gretchen Jacobson, a
Medicare expert with the California-based Kaiser Family Foundation. She noted
that Medicare enrollees still have the chance to make changes.
“One
important question is: How much will these numbers change during the next two
months when people are able to look at their plan a little more closely and
decide if they really want to stick with it?” Jacobson said. Those who lost
Cost plans “have a choice and a rare period where they are guaranteed to be
issued a Medigap policy if they want it.”
MA
plans have been gaining market share across the country as the nation’s largest
health insurers see a growing business opportunity.
Supporters
say the trend leads to better coordination of care for patients plus extra
benefits with relatively low premiums. Critics fear that too many seniors don’t
appreciate how the coverage can affect their choice of doctors and prescription
drug plans.
For
many years, Cost plans have been a big business for the state’s three largest
nonprofit health insurers — Blue Cross and Blue Shield of Minnesota,
HealthPartners and Medica. A Star Tribune review of government data for
December and January shows that while the insurers collectively lost about
330,000 enrollees in Cost plans, they grew their MA enrollment by about 135,000
people.
While
the numbers suggest a decline in market share for the companies, the loss is
mitigated by former Cost plan enrollees who opted for original Medicare and now
are buying a Medigap policy from their old insurer.
Blue
Cross, which has been by far the largest Medicare Cost plan in the state, lost
about 206,000 Cost plan enrollees while adding about 89,000 Medicare Advantage
plan enrollees. At the same time, the company says it more than doubled its
tally of Medigap customers, which previously stood at about 80,000 people.
When
it’s all said and done, Blue Cross saw some decline in its Medicare enrollment,
but “we’re pleased with our retention results,” said Monica Engel, president of
the insurance company’s Medicare business.
Overall
Medicare enrollment also declined at HealthPartners and Medica, where officials
say the insurers saw a bigger drop in Medicare Cost enrollment than the
simultaneous jumps in Medigap and Medicare Advantage. At Medica, increased
competition was a factor in the decline, along with the decision to not sell
Medicare Advantage plans across all counties, said Tom Lindquist, a senior vice
president with the insurer.
While
the overall figures show a statewide decrease of 330,000 people in Cost plans,
the data release doesn’t show precisely where those enrollees went in terms of
their coverage, Lindquist noted. So, while the simultaneous jump of more than
200,000 people in MA enrollment might suggest two-thirds of the Cost plan
enrollees opted for MA, Lindquist thinks the share is likely between 50 percent
and 60 percent. Some of the MA growth, he said, likely came from people who
newly qualified for Medicare.
“This
is just the first year of the transition, which, as far as I’m concerned, is
going to be a two- to three-year process,” Lindquist said. “You’ll see shifts
back and forth between Advantage and [Medigap] as people settle in and figure
out what they have.”
The
enrollment numbers show that Humana and UCare, which have sold Medicare
Advantage plans for many years in Minnesota, collectively added more than
62,000 enrollees, with the majority going to Humana. The Kentucky-based health
insurer did not comment.
Ghita
Worcester, a senior vice president at UCare, said the Minneapolis-based HMO has
seen a significant increase in sign-ups since the cutoff for collecting the
data released last week. The latest numbers aren’t final, Worcester added,
because of ongoing enrollment chances.
There’s
a special “guaranteed issue” right to purchase a Medicare Supplement policy
until March 4 for those who lost Cost plans; they also have
options related to Part D plans through the end of February. Finally, there’s
an extra open enrollment period for MA plans that extends to March 31.
The
big shift brought new players to the state’s Medicare market for 2019. New
entrant Allina Health Aetna added 5,200 MA enrollees, the data show, while
newcomer UnitedHealthcare picked up more than 2,300.
MaryJo Webster contributed to this report.
Christopher Snowbeck covers health insurers, including
Minnetonka-based UnitedHealth Group, and the business of running hospitals and
clinics.
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