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Blues to end Medicare HMO in some areas
By KRIS HUNDLEY, Times Staff Writer About 6,200 Tampa Bay area residents will lose their Medicare HMO next year as BlueCross BlueShield of Florida ends its participation in the federal health insurance program for seniors in Pinellas as well as two other Florida counties. The Jacksonville insurer said Monday it will continue its Medicare & More program only in Palm Beach, Broward and Miami/Dade counties, where reimbursement rates are higher. BlueCross also is withdrawing from Duval and Clay counties. About 20,000 Florida seniors will be forced to find another HMO or return to traditional Medicare coverage as a result of the decision by BlueCross BlueShield. The Blues' decision came on the day health plans were required to submit their Medicare HMO plans for 2003 to the federal government. The American Association of Health Plans said a survey of its members showed that about 200,000 seniors nationwide will lose their Medicare HMOs next year because of plan withdrawals. It is the fifth consecutive year health plans have fled the program, blaming inadequate government reimbursements. Last year, an estimated 536,000 beneficiaries were forced out of plans because of withdrawal decisions. Last year, BlueCross dropped out of Medicare HMOs in seven counties, including Hillsborough, Pasco and parts of Pinellas. It retained coverage only for residents of 45 ZIP codes in mid-Pinellas; that program will end Dec. 31. W. Charles Scott, vice president of the over-65 market for BlueCross, said government reimbursements for Medicare HMOs, increasing about 2 percent a year, have fallen far short of medical inflation. "Overall health care costs are rising 10 to 15 percent while pharmaceuticals are in the range of 20 percent," Scott said. "Unless Congress does something to provide substantially more funding, this program is doomed to failure." Next year, the federal government will reimburse Medicare HMOs in the Tampa Bay area the following amounts per member per month: in Hernando County, $581.55; Hillsborough, $564.10; Pasco, $613.45; and Pinellas, $571.17. In each case, the figure represents a 2 percent increase over 2002 reimbursement rates. Scott said his company supports a bill that has passed the House of Representatives but has not yet been taken up by the Senate, which would pay Medicare HMOs the equivalent of what the government is spending in the traditional Medicare program for 2003, then cap future increases at 3 percent. The Bush administration has proposed adding $7-billion to Medicare HMO reimbursements over the next five years. While the Blues are exiting the Tampa Bay area's Medicare HMO market, one competitor said it will stay. Humana Inc., which has Medicare HMOs in Pinellas, Pasco and Hillsborough counties, said it will remain in all its Florida markets, though there will be benefit changes. United HealthCare and Well Care, which both offer Medicare HMOs in Pinellas, Pasco and Hillsborough as well as Hernando counties, did not respond to calls about their plans for 2003. Complete information on Medicare HMO carriers and their benefit packages will be accessible on the Internet (www.medicare.gov) by the end of October. Open enrollment in Medicare HMOs for the coming year will be from Nov. 15 to the end of December. -- Kris Hundley can be reached at hundley@sptimes.com or (727)892-2996.
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From the Times Business report
From the AP
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