Vermonters to be billed for Medicaid

back

Vermonters to be billed for Medicaid

Associated Press via Concord Monitor

October 14, 2003

Nearly 36,600 Vermonters will begin receiving monthly premium bills soon for their state-subsidized health care.

The bills, from $5 to $75, will replace the co-payments that participants in Vermont 's Medicaid-related health and pharmacy programs paid for their services.

"We've gotten a clear mandate to switch to this system, and our job is to make sure that it is deployed on time," said John Michael Hall, commissioner of the department of Prevention, Assistance, Transition and Health Access.

The bills will start going out at the end of next month for premiums due at the end of December. Participants could lose their health insurance if they fail to pay on time.

The change was signed into law by Gov. James Douglas in June.

The state's chief health-care advocate said Monday that she was surprised to learn that the welfare department was going forward with the switch, and said she would ask for a delay.

"I don't think the department is ready to institute the premium system," said Donna Sutton-Fay, Vermont 's health-care ombudsman. "I have a lot of concerns."

When the Legislature was changing the way Vermont 's poor pay for their health insurance, Sutton-Fay and others were concerned that a monthly premium would be a challenge for many families, and that many would fail to pay on time and lose coverage.

She noted that the department had not completed any educational programs to help participants make the change, and said she was worried the department wasn't equipped to process premium payments on time.

Hall said the department is ready.

"I am confident that on Nov. 28, the bills will go out," he said.

The change affects those participating in programs such as Dr. Dynasaur, the Vermont Health Access Plan, Vscript and VHAP Pharmacy, as well as others who are ineligible for traditional Medicaid but who do not obtain - or cannot afford - other health insurance.

In the last several years, Vermont has expanded Medicaid coverage to people who would not qualify for the traditional Medicaid programs. It is in these expanded programs - affecting nearly a quarter of the state's Medicaid recipients - that the premiums will be charged.

The premiums are expected to generate about $15 million a year, nearly the same amount that participants in the plans paid in co-payments.