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Oakland. Most California seniors enrolled in a Medicare HMO will be able to keep their coverage next year, despite the rash of managed care pullouts from Medicare throughout the country. That’s because Kaiser Permanente and PacifiCare – which hold 70 percent of California’s Medicare managed care contracts – are staying put. "We’re very lucky," said Jack Christy, JD, director of the California Medicare Project. "Kaiser is a big player here." California has 3.9 million Medicare beneficiaries; 1.5 million are enrolled in an HMO. But the state has had its share of pullouts. As of Jan. 1, eight managed care plans in California either will cut back or withdraw from the Medicare market, according to a report by the California Medicare Project, a program of the Oakland-based California Health Care Foundation. Dropping a combined 57,000 members are CIGNA, Aetna, Blue Cross, Blue Shield, National Health Plans, UC San Diego, Health Net and Maxicare. Most Medicare beneficiaries dropped by their managed care plans still will have a choice of another HMO in their area, Christy said. Nationwide, the Health Care Financing Administration also announced last week that 118 plans will stop serving 933,687 Medicare beneficiaries next year. The HMOs said insufficient reimbursement rates were the chief reason. Although seniors dropped by their HMOs will not lose their Medicare coverage, many may have to switch doctors and start paying for prescription drugs out of pocket. |
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