Insurers change Medicare Advantage plans in the Treasure Valley [The Idaho Statesman]

Oct. 10--Some seniors in the Treasure Valley have received word from Blue Cross of Idaho that their Secure Blue Medicare plan won't be offered next year. Others got word from Regence BlueShield of Idaho that their MedAdvantage Basic PPO plan will be discontinued.

For both groups, coverage ends Dec. 31.

"You need to make some decisions about your Medicare coverage. If you don't take action before Dec. 31, you will lose your prescription drug coverage and only have original Medicare starting Jan. 1, 2013," said a letter sent by Blue Cross of IdahoOct. 2 to a Boise resident.

The plans are among the Medicare Advantage plans offered to Idahoans by insurers. A Medicare Advantage plan is a type of health plan offered by a private company that contracts with Medicare to provide Medicare recipients with all of their Part A (basic hospital) and Part B (nonhospital medical care) benefits.

Blue Cross of Idaho told members they can enroll in a new plan between Oct. 15 and Feb. 28, 2013. If they don't, they might have to pay a penalty that is tacked on to Medicare prescription drug plans after a person enrolls late.

DOES THAT MEAN SENIORS WON'T HAVE INSURANCE?

Not necessarily. But thousands of seniors in the Treasure Valley must sign up for another plan to maintain their coverage.

Blue Cross and Regence members can re-enroll in a new version of the plan just for Treasure Valley residents. The envelope from Blue Cross of Idaho included a personalized enrollment form the member could sign and mail back with a postage-paid envelope, said spokeswoman Karen Early.

WHAT CHANGED?

Both insurers created a version of the Medicare Advantage plans just for Ada, Boise, Canyon, Gem and Owyhee county residents.

WHY IS THIS HAPPENING?

The federal government pays a different rate for Medicare Advantage members in different counties. For example, the rate might be lower in a rural county. "Every year it changes. ... The changes were significant enough this year to make a difference," Early said.

DOES THE NEW PLAN COST MORE?

It could. Seniors should check their plan overviews or contact their insurers to find out.

For the new Blue Cross plan, the premium is $3 more per month with prescription drug coverage. Benefits are the same. It will still cost $20 to have office visits with in-network providers, but out-of-network office visits will increase to $40.

Members outside of the five-county area will pay $33$54 in 2012 to zero dollars. Under this plan, doctor-office visits will still have a $15 copay for in-network providers and $35 for out-of-network providers.

LOCAL REACTION

The switchover and the higher-cost plan upset some Treasure Valley residents.

Robert Rychert, 70, of Boise, and his 66-year-old wife both have Secure Blue plans. But their doctor of choice takes insurance through UnitedHealthcare, one of the country's largest Medicare Advantage insurance providers. The out-of-pocket copayment for an office visit will be about $35 higher with the new Secure Blue plan, he said.

Rychert had stuck with Blue Cross of Idaho for the past couple of years because "they were a local provider, and we've always been able to work with them," he said. "But in the interest of cost savings, we're going to switch."

Audrey Dutton: 377-6448, Twitter: @IDS_Audrey

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