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
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.