Thousands Of Brevard Seniors Lose Insurance Coverage

By  //  April 12, 2013

Share on Facebook Share on Twitter Share on LinkedIn Share on Delicious Digg This Stumble This

Universal Health Care Shut Down By State

BREVARD COUNTY • MERRITT ISLAND, FLORIDA — Approximately 3,000 Brevard County seniors are now faced with finding an alternative to their Universal Health Care Medicare Advantage plan.

MISMANAGEMENT, FRAUD LED TO LIQUIDATION

Approximately 3,000 Brevard County seniors are now faced with finding an alternative to their Universal Health Care Medicare Advantage plan.

The St. Petersburg Medicare and Medicaid HMO company was turned over to the Florida Division of Financial Services for liquidation as of April 1 after being declared insolvent and accused of financial mismanagement and possible fraud, leaving 100,000 Medicare and Medicaid Florida beneficiaries enrolled in Universal plans without coverage.

With the state moving quickly, and the Universal Health Care shutdown occurring unusually rapidly, the quandary for the beneficiaries is what happens to their existing liabilities for services in the recent past and scheduled in the near future, and where can they find comparable policies that won’t be more expensive and leave gaps in their coverage?

MA POPULAR, AFFORDABLE & COST EFFECTIVE

The Medicare Advantage  (MA) plan program is a very popular, affordable and cost effective alternative to traditional Medicare, which offers care to seniors through private insurers that contract with the Centers for Medicare and Medicaid Services (CMS).  MA coverage is offered by more than 3,000 private plans and serves nearly 13 million beneficiaries, which comprises 27 percent of the Medicare population, and of which almost 43,000 live in Brevard County.

EX-BENEFICIARIES ON THEIR OWN TO FIND COMPARABLE COVERAGE

Universal MA members may default to regular Medicare plans while searching for another insurer, but neither the federal government, the state nor other insurers has an affirmative legal obligation to offer policyholders the same coverage they had or help them defray the cost differences.

The Florida Division of Financial Services officials have not said what help they will offer, if any, to the unfortunate ex-beneficiaries who find themselves with no coverage, or what options people have for seeking alternative coverage.

One of the biggest challenges for Universal policyholders will be to find a plan with a provider panel that includes their physicians especially if they are seeing multiple physicians for different conditions.

One of the biggest challenges for Universal policyholders is finding a plan with a provider network that includes their physicians, especially if they are seeing multiple physicians for different conditions. They also face the possibility of higher premiums and co-pays with fewer benefits, such as vision and dental coverage.

Health First Health Plans, with its county-wide provider network, customized offerings and four and a half  (out of 5) star quality rating, is the predominant MA insurer in Brevard – covering over 50 percent of the 43,000 seniors enrolled in MA plans.  Humana is a distant second at 11 percent, and Wellcare third with 8 percent of the market.

The rules and regulations related to switching Medicare plans can be confusing. Beneficiaries can go online to Medicare.gov or call 1-800-MEDICARE  for information and advice.

They can also call a volunteer at SHINE (Serving Health Insurance Needs of Elders) at the Elder Helpline, 800-963-5337, or find local counseling sites and contacts at FloridaShine/Brevard.


Click here to contribute your news or announcements Free