A few Medicare managed-care plans will raise premiums in Stanislaus County

Oct. 26--Counselors did not discuss many changes for the Medicare program next year, but some of the 250 seniors who attended an informational meeting last week in Modesto will see higher premiums for their managed-care plans in January.

Eight insurers offer Medicare Advantage plans in Stanislaus County, providing additional medical services on top of the basic Medicare benefits for people age 65 and older.

Effective Jan. 1, Humana will charge $75 monthly for its top plan, an increase over the premium this year. Humana has a more basic health plan with no monthly premium, though the co-payments and out-of-pocket maximum are higher.

Care 1st Advantage Optimum will cost $48 a month, a $3 increase. The plan has no co-payments for physician visits, and the hospitalization co-pay will remain $150 daily for the first five days.

Kaiser Permanente Senior Advantage will charge $2 more per month for its enhanced plan, which was $72 a month this year. Kaiser's basic plan will remain at $10 a month.

The most expensive plan on the list, Health Net Healthy Heart, will increase $1 to $163 a month. No premium increases were announced for CareMore, AARP Secure Horizons and Alignment Health Plan. Alignment is the new name for the plan formerly known as Citizens Choice.

The monthly premiums for Medicare Advantage plans are on top of the Medicare Part B charge deducted from Social Security checks. The Part B premium was $104.90 this year.

Golden State Medicare Health Plan is available to seniors in Stanislaus County for the first time in 2016. The HMO-style plan that originated in Southern California has no monthly premium and no co-pays for physician services, hospital stays and outpatient surgery, according to information provided at Thursday's meeting.

Golden State's co-pays for prescription drugs range from $5 for common medications to one-third of costs for the most specialized drugs. It has dental coverage, and the out-of-pocket maximum for medical services is $3,400 for the year.

The Easy Choice Health Plan has notified customers it will no longer serve Stanislaus County. People enrolled in Easy Choice will need to choose another option for 2016. Medicare's fall enrollment period for signups or making changes to coverage runs through Dec. 7.

The Health Insurance Counseling and Advocacy Program held Thursday's meeting at Modesto Senior Center to help people understand the Medicare program.

Sandy Howell, an insurance counselor for HICAP, said seniors need to make sure the Medicare Advantage plan they choose has a provider network that includes their physicians and preferred hospital. Seniors also need to make sure their medications are covered.

The managed-care plans require members to have a primary-care doctor to direct their care.

The health plans cover urgent care and emergency-room service for members who are traveling in other states. In answer to a question from the audience, speakers said that people who live a few months of the year in another state, can inquire about Medicare supplemental insurance for the months they are outside California.

HICAP will hold another informational meeting Wednesday at 9 a.m. at Hammon Senior Center, 1033 W. Las Palmas Ave. in Patterson.

The HICAP office at 121 Downey Ave. in Modesto offers free assistance for people trying to navigate the Medicare system. It is open weekdays from 8:30 a.m. to 4:30 p.m. Call 209-558-4540.

Ken Carlson: 209-578-2321

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