Premier drops MediGold Medicare Advantage

Oct. 15--Premier Health, the Dayton-area's largest hospital network, has notified an undisclosed number of Medicare patients that it will no longer accept MediGold Medicare Advantage plans, a network spokeswoman said Wednesday.

Premier's Diane Ewing said MediGold patients that used Premier services in the past 12 months were notified about the change on Oct. 1.

Open enrollment for new Medicare plans began Wednesday and runs through Dec. 7. Displaced MediGold patients have until the end of the enrollment period to sign up for different Medicare Advantage plans that include Premier in their provider networks. More than a dozen insurers sell Medicare Advantage plans in the Dayton area.

Unlike traditional Medicare -- the federal health insurance program for people 65 and older and younger people with disabilities -- Medicare Advantage plans are sold through private health insurance companies and cover more than original Medicare, including wellness programs and vision care.

Premier Health will offer its own Medicare Advantage plan next year as part of its move into the commercial health insurance business, which includes selling group and individual health plans on Ohio's health insurance marketplace, created by the Affordable Care Act.

The federal government will pay commercial insurers, including Premier, a per-capita fee to manage benefits.

But the Obama administration plans to cut those extra payments to insurers by about $150 billion over the next 10 years to help pay for the health care law led the nation's largest Medicare Advantage insurer -- United HealthCare -- to cull doctors from its provider network earlier this year.

United Healthcare's decision to drop hundreds of physicians from its Medicare Advantage plan affected more than a dozen practices across the state and forced thousands of policyholders to switch plans.

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