Blue Cross Blue Shield drops HMO plans in 11 counties
By Alex Dixon, The Herald-Sun, Durham, N.C. | |
McClatchy-Tribune Information Services |
The counties include:
Under HMO plans, beneficiaries generally must get care from within the plan's network as opposed to PPO plans, which contracts with a network of preferred providers to which the beneficiary can choose.
According to the letter, if Snider does not take action before
"This is a shock to everybody," Snider said. "We wish they still offered (the old plans.)"
Snider said her monthly premium for Blue Medicare HMO Enhanced was
The BCBSNC letter does not outline the new plan offerings or specifics because they are not made public until
However, according to CMS data that shows approved plan premiums for 2015, the only available HMO plan with drug coverage from BCBSNC in
"There are some people out here who choose between health care and food," she said about potential price increases. "If you're caught in the middle, there's nothing you can do."
The changes do not affect BCBSNC's provider network and only affect individual members, not employers, Douglas said.
According to the letter, those affected have the option to join another
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Geographically, nine of the 11 counties border each other in the northwestern part of the state.
According to calculations based on government data from 2012, about 20 percent of the population across the 11 counties is enrolled in
Douglas said in an email that BCBSNC made the decision to drop the plans based on the overall performance of the plans in these areas as well as changes in CMS reimbursements for
"I can tell you that the 11 counties where we will no longer offer the Blue Medicare HMO Enhanced/Select plans are the counties with most significant federal government reimbursement impact," she said.
But Hall said the
"The SHIIP program is very helpful," Snider said.
On Thursday, the CMS released a report that said the average premium submitted by health plans would increase by
The report also highlights that the average premium for a basic
"Because of the Affordable Care Act, people with
The report projects that enrollment in
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