UnitedHealthcare, the nation’s largest Medicare provider, is eliminating certain Medicare Advantage health plans next year for nearly 4,000 members in Hawaii.
The majority of affected members live in Hawaii, Kauai and Maui counties, and fewer than 100 are on Oahu, the company said in a statement to the Honolulu Star-Advertiser.
The for-profit health insurer will still offer about eight Medicare plans. UnitedHealthcare has about 20,500 members in Hawaii, including the 4,000 whose plans will no longer be offered.
UnitedHealthcare said it decided to cut some of its Advantage plans because of increasing health care costs, changes in Medicare rules and government funding for the program as a result of rate reductions under President Barack Obama’s Affordable Care Act, sequestration cuts and new insurance premium taxes.
"While making these changes, our priorities were to minimize disruption to our members and their access to health care, make our plans as affordable as possible, and ensure we can continue to offer our plans in the years ahead," Dave Heywood, vice president of UnitedHealthcare Hawaii, said in a statement. "In some cases, (the changes) required us to leave some markets or to close plans. We know that some of our members will experience disruption in their plan for 2014 as a result of these decisions, which we regret. While these decisions were difficult, they were necessary to ensure that our plans remain sustainable for members not just in 2014 but for the long term."
The coverage will end on Dec. 31.
Open enrollment for Medicare runs from Oct. 15 through Dec. 7.
The plan UnitedHealthcare is ending is called MedicareComplete Choice, but the company will continue to offer an AARP MedicareComplete Choice plan in 2014.
In addition, beneficiaries eligible for both Medicare and Medicaid can enroll in UnitedHealthcare’s Medicare Advantage Dual Special Needs Plan that will be available on Kauai, Maui, Lanai, Molokai and Hawaii island. It also will continue to offer the Medicare supplement and Part D prescription drug plans.
Medicare Advantage plans are offered by companies that contract with Medicare to provide Part A and Part B benefits, which cover doctor and hospital visits. Most Advantage plans also offer prescription drug coverage.
Representatives of Hawaii Medical Service Association, Kaiser Permanente Hawaii, ‘Ohana Health Plan and AlohaCare said they will continue to offer Advantage plans in 2014.
"The closing of the Medicare Advantage plans highlight the long-term challenges facing Medicare and their beneficiaries," said Barbara Kim Stanton, AARP Hawaii state director. "What we need to do is look to sensible reforms that are not going to hurt Medicare beneficiaries, such as clamping down on drug companies’ high prices and reducing waste and inefficiency and seeing what we can do to coordinate patient care. Without these things there’s going to be fewer and fewer options for the seniors. What we don’t want to see is Medicare beneficiaries hurt by some of these insurance business decisions."
UnitedHealthcare offers Advantage plans in 44 states; Washington, D.C.; and most major metropolitan areas.
The company notified affected members of the plan closures earlier this month. For more information, call UnitedHealthcare’s customer service center on Oahu at 866-238-7220.