Elderly Worry as Insurers Cut Medicare Plans in Connecticut

By: The Associated Press
The New York Times, December 26, 2000

More than 50,000 elderly and disabled Connecticut residents are being forced to change health insurance carriers by Jan. 1 because many health maintenance organizations are getting out of the Medicare market.

As a result, thousands must either change health plans or return to traditional Medicare, which does not cover costly prescriptions.

And time is running out.

"People are frantic," said Eric Rodko, coordinator for Choices, an affiliate of the Western Connecticut Area Agency on Aging Inc., a nonprofit group that provides services to the elderly. He said his agency fielded about 5,000 phone calls.

"Premiums are quite high," Mr. Rodko said. "And they're suddenly having to pay more out of pocket for prescription drugs. Never mind the oil bills. Out-of-pocket costs for health care are escalating. And it's likely they will keep rising."

Several insurance companies are dropping their Medicare H.M.O. businesses because they say federal reimbursement is not profitable. And those that are not dropping their Medicare H.M.O.'s are raising their rates.

"Our choice was reflective of issues facing the program throughout the country," said Carol Pompano, a spokeswoman for Anthem Blue Cross/Blue Shield. "Current funding levels and regulatory requirements just didn't make it viable. Funding levels didn't justify staying in the market. Anthem was losing money. Reimbursements remained flat. Our costs were increasing."

Others pulling out of the Medicare H.M.O. business include Aetna U.S. Healthcare and Cigna Health Care for Seniors.

Some insurers, including MedSpan Health Options Inc. and ConnectiCare 65, have either closed enrollments altogether or closed them to people living in certain counties. Others offer "Medigap" policies, which help cover services traditional Medicare does not for an additional monthly fee.

Mr. Rodko said that anyone who was overwhelmed or confused by having to make a quick decision should contact an Agency on Aging office.

Average Medigap policies cost $100 to $125 a month and consumers should make sure the policy fits their needs before buying, Mr. Rodko said.

William and Adelaide Grenier of Watertown have struggled with health insurance since August. The couple, in their 70's, switched to MedSpan Medicare Options when Waterbury Hospital dropped its contract with Medicare Blue Connecticut on Sept. 1.

This month, Mrs. Grenier had a hip replacement and said she was told that her insurer would not pay for her to temporarily go to an inpatient rehabilitation center once she left the hospital. Mr. Grenier has cancer and said it was hard for him to properly care for her.

Now, the couple's doctor is ending his contract with MedSpan, so the Greniers are switching policies back to traditional Medicare. The new plan, their third in six months, takes effect Jan. 1.