WEISS RATINGSAdvice For 536,000 Medicare BeneficiariesBeing Dropped From Their HMOs On January 1 |
| California, Florida, Pennsylvania and New Jersey Hit Hardest |
PALM BEACH GARDENS, Fla., October 29, 2001 — By year-end 2001, more than 536,000 seniors on Medicare will be dropped from their HMOs, on top of the 1.6 million that have already been dropped since 1998. The affected enrollees, living in 28 states, will be forced to find alternative coverage before December 31, 2001.
"This is just the latest in a long series of blows to the elderly," commented Martin D. Weiss, Ph.D., chairman of Weiss Ratings, Inc., the only provider of safety ratings on most HMOs and Blue Cross Blue Shield plans. "Insufficient federal funding and rising medical costs have pushed many HMOs to dump their elderly enrollees, boost out-of-pocket expenses for remaining members and reduce medical benefits overall."
Fifty-four HMOs are either withdrawing from Medicare completely or reducing their service areas, with eight individual HMOs dropping more than 20,000 enrollees each:
| HMO1 | Weiss Safety Ratings2 |
Number of Seniors Dropped3 |
State(s) in Which Coverage is Affected3 |
| Aetna Life Insurance Company | C+ | 54,561 | Pa. |
| Aetna U.S. Healthcare, Inc. | B- | 38,383 | N.J. |
| Connecticare, Inc. | B- | 24,438 | Conn. |
| Health Options, Inc. | B | 37,970 | Fla. |
| Humana Health Plan, Inc. | C+ | 21,647 | Ill., Ind., Ky. |
| Pacificare of California / Secure Horizons | C- | 35,797 | Calif. |
| Pacificare of Texas, Inc. | D+ | 25,262 | Texas |
| United Healthcare of Illinois, Inc. | C | 32,775 | Ill. |
The 10 states with the largest number of seniors being dropped from their Medicare HMOs are:
| State | Affected Enrollees3 |
| Calif. | 83,634 |
| Fla. | 59,348 |
| Pa. | 54,561 |
| N.J. | 53,144 |
| Texas | 45,977 |
| Ill. | 40,539 |
| Conn. | 38,785 |
| Mich. | 31,446 |
| Ark. | 16,841 |
| N.Y. | 15,590 |
For Medicare beneficiaries who will be losing their coverage by the end of the year, Dr. Weiss offers the following advice:
Start checking into alternative coverage immediately. To avoid any coverage gaps, enroll between now and December 31 in a new policy that will take effect no later than January 1, 2002. Your current HMO that is dropping you is required to provide you a list of HMOs in your area that are still providing Medicare coverage. Contact the Medicare+Choice Help line at 1-800-MEDICARE if you did not receive this information. Be forewarned, however, that some HMOs are not accepting new Medicare patients, and even those that do accept you now may decide to drop you in the near future.
Avoid HMOs if you can. Unless the federal government makes drastic changes to the Medicare+Choice program making it more attractive to HMOs, the trend of companies pulling out of the program will continue. Thus, enrolling in yet another HMO will put you at risk of joining the hundreds of thousands additional Medicare beneficiaries who will likely lose their coverage in the next few years.
Seriously consider leaving HMOs entirely and shifting to traditional Medicare along with a supplemental insurance policy. You are guaranteed eligibility in Medicare supplement insurance ("Medigap") regardless of your health status. Under this guarantee, you can choose among four different Medigap plans -- called Plans A, B, C and F. Depending on your health, you may also be eligible for the six other Medigap plans available. With Medicare and Medigap, it's far less likely you will get dropped again. Plus, you will have more freedom to choose your provider or hospital and will benefit from better access to specialists.
Warning: You have 63 days from the date you leave your current HMO to take advantage of this guarantee, with the last possible day being March 4, if you waited until December 31 to switch.
Shop around for the least expensive Medigap policy that meets your needs. The cost of Medigap insurance can vary drastically by insurance provider, even for identical plans offering the same benefits in the same location. For example, a 65-year-old male in Saginaw, Mich. could pay $1,278.86 for Plan A from Bankers Life and Casualty Company, but only $595.65 if he signed up with Standard Life and Accident Insurance Company. He would pay $2,149.80 for Plan C with Mutual of Omaha Insurance Company, but only $965 for the identical Medigap policy with Continental Life Insurance Company of Brentwood, Tenn. Likewise, he would pay $1,835.70 for Plan F with Guarantee Trust Life Insurance Company, but only $991 for Plan F with Standard Life and Accident Insurance Company.
Weiss Ratings, Inc. is the only provider of a complete shopper's guide to Medigap insurance for consumers. Customized for each person, the "Health Insurance Guide For Seniors" is based on the senior's age, gender and address, and provides a full listing of available data of all insurance providers, policies, and actual quotes for each of the ten Medigap plans, "A" through "J." In addition, it includes the latest Weiss Safety Rating for each insurer, along with a complete list of the benefits of each Medigap plan.
Weiss issues safety ratings on more than 15,000 financial institutions, including HMOs, life and health insurers, Blue Cross Blue Shield plans, property and casualty insurers, banks, and brokers. Weiss also rates the risk-adjusted performance of more than 11,000 mutual funds. Weiss Ratings is the only major rating agency that receives no compensation from the companies it rates. Revenues are derived strictly from sales of its products to consumers, businesses, and libraries.
Consumers needing more information on the financial safety of a specific company can purchase a rating and summary analysis for as little as $7.95 through the Weiss Ratings web site at www.WeissRatings.com, or starting at $15 by calling (800) 289-9222.
Available from Weiss Ratings is a customized "Health Insurance Report for Seniors.
| Weiss Ratings, Inc. |
Companies Withdrawing Fully or Partially
From Medicare+Choice
| HMO1 | Weiss Safety Ratings2 |
Number of Seniors Dropped3 |
State(s) in Which Coverage is Affected3 |
| Aetna Life Insurance Company | C+ | 54,561 | Pa. |
| Aetna U.S. Healthcare, Inc. | B- | 38,383 | N.J. |
| Health Options, Inc | B | 37,970 | Fla. |
| Pacificare of California / Secure Horizons | C- | 35,797 | Calif. |
| United Healthcare of Illinois, Inc. | C | 32,775 | Ill. |
| Pacificare of Texas, Inc. | D+ | 25,262 | Texas |
| Connecticare, Inc. | B- | 24,438 | Conn. |
| Humana Health Plan, Inc. | C+ | 21,647 | Ill., Ind., Ky. |
| Health Net of Ca | B | 19,870 | Calif. |
| Texas Health Choice, L.C. | D+ | 19,236 | Texas |
| Blue Care Network — Southeast Michigan | C | 16,940 | Mich. |
| United Healthcare of Florida, Inc. | C | 14,364 | Fla. |
| Medspan Health Options, Inc. | D+ | 14,347 | Conn. |
| Oxford Health Plans (NY), Inc. | C- | 13,885 | N.Y. |
| CA Physicians Serv/DBA Blue Shield of Calif. | A- | 11,787 | Calif. |
| Amerihealth HMO, Inc. | B | 11,333 | N.J. |
| Blue Cross & Blue Shield United of Wisconsin | C- | 10,366 | Wis. |
| Premera Blue Cross | C+ | 9,967 | Wash. |
| HMO Partners / Health Advantage | C- | 9,691 | Ark. |
| HMO Colorado, Inc. | C | 9,250 | Colo. |
| National Med, Inc. | D+ | 9,012 | Calif. |
| MCare | C- | 8,279 | Mich. |
| United Healthcare of Arkansas, Inc. | B | 7,150 | Ark. |
| Blue Cross Blue Shield of Kansas City | B- | 6,917 | Mo., Kan. |
| Aetna U.S. Healthcare, Inc. | C | 6,003 | Ariz. |
| Family Health Plan, Inc. | E | 5,579 | Ohio |
| Aetna U.S. Healthcare of California, Inc. | C+ | 4,931 | Calif. |
| Pacificare of Arizona, Inc. | C+ | 4,906 | Ariz. |
| Av-Med Health Plan, Inc. | D | 4,836 | Fla. |
| Preferred Plus of Kansas, Inc. | B- | 4,813 | Kan. |
| Selectcare HMO, Inc. | U | 4,635 | Mich. |
| Renaissance HMO, Inc. | E | 4,159 | Ohio |
| Oxford Health Plans (NJ), Inc. | C- | 2,926 | N.J. |
| The Oath of Alabama, Inc. | E+ | 2,733 | Ala. |
| Health Plan Hawaii | C | 2,666 | Hawaii |
| Sterling Life Insurance Company | C | 2,521 | Miss., Texas |
| Beacon Health Plans, Inc. | E- | 2,178 | Fla. |
| United Healthcare of Ohio, Inc. | C+ | 2,176 | Ohio |
| Advantage Health Plan, Inc. | U | 2,175 | Ind. |
| Community Care HMO, Inc. | E+ | 1,714 | Okla. |
| Blue Cross of California | A- | 1,676 | Calif. |
| Health Alliance Plan of Michigan | A | 1,592 | Mich. |
| Community Health of Ohio | E+ | 1,554 | Ohio. |
| HIP of Greater New York | D- | 1,281 | N.Y. |
| Pacificare of Washington, Inc. | U | 933 | Wash. |
| Blue Cross Blue Shield of DE, Inc. | B | 815 | Del. |
| Pacificare of Oklahoma, Inc. | B- | 804 | Okla. |
| Inter Valley Health Plan, Inc. | U | 561 | Calif. |
| Health Plan of the Upper Ohio Valley | B- | 543 | W.Va., Ohio |
| Americhoice of New Jersey, Inc. | C+ | 502 | N.J. |
| Pacificare of Oregon, Inc. | B- | 442 | Ore. |
| Health Net of NY5 | 424 | N.Y. | |
| Kaiser Foundation HP of GA, Inc. | C | 348 | Ga. |
| Fallon Community Health Plans, Inc. | C | 12 | Mass. |
| Out of Area4 | 2,804 | ||
| Total | 536,469 | ||
| Weiss Ratings, Inc. |
Number of Seniors Being Dropped By State
| State | Affected Enrollees | ||
| Calif. | 83,634 | ||
| Fla. | 59,348 | ||
| Pa. | 54,561 | ||
| N.J. | 53,144 | ||
| Texas | 45,977 | ||
| Ill. | 40,539 | ||
| Conn. | 38,785 | ||
| Mich. | 31,446 | ||
| Ark. | 16,841 | ||
| N.Y. | 15,590 | ||
| Ohio | 13,993 | ||
| Ky. | 12,041 | ||
| Ariz. | 10,909 | ||
| Wash. | 10,900 | ||
| Wis. | 10,366 | ||
| Colo. | 9,250 | ||
| Kan. | 6,765 | ||
| Mo. | 4,965 | ||
| Ind. | 4,017 | ||
| Out of Area | 2,804 | ||
| Ala. | 2,733 | ||
| Hawaii | 2,666 | ||
| Okla. | 2,518 | ||
| Miss. | 1,042 | ||
| Del. | 815 | ||
| Ore. | 442 | ||
| Ga. | 348 | ||
| W.Va. | 18 | ||
| Mass. | 12 | ||
| Total | 536,469 | ||
Data Source: Centers for Medicare and Medicaid Services, formerly HCFA
(www.cms.hhs.gov/lplans/nonrenewal)
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