Insurance companies vying to attract local Medicare users

Bill Lackey/Staff

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Bill Lackey/Staff

Insurance companies are scrambling to attract seniors in the Dayton area with soon-to-be discontinued Medicare Advantage plans through Premier Health.

Premier, which also operates four Dayton-area hospitals, is shutting down its Medicare Advantage insurance business line by March 31.

Now health insurance companies have flooded the region with advertising, trying to solicit the 9,500 people who were with Premier Health and are now searching for a new option.

RELATED: Premier says insurance business didn’t gain enough customers

Chris Reeg, program director for Ohio Senior Health Insurance Program, said her state program has been getting a lot of questions from confused seniors. There are more than 30 Medicare Advantage options in Montgomery County for residents to chose from.

Reeg said residents will need to carefully shop to make sure that they get the plan that’s right for them. Medicare Advantage Ohio — the privatized version of the federal insurance program — now accounts for 37 percent of all Medicare plans in the U.S.

While the percent of Medicare Advantage plans in Ohio only grew about 1 percent, it’s nationally proven to be a growing and lucrative business in the insurance industry.

Gretchen Jacobson, associate director with the Kaiser Family Foundation’s Program on Medicare Policy, said people tend not to change their coverage options from year to year so from the insurers’ perspectives, it’s a “ripe opportunity” now that thousands of people have to search for new plans.

“From a business standpoint it makes sense that they are going full tilt into advertising to these beneficiaries,” she said.

LOCAL: Local hospitals penalized for high readmission rates

The percent of local adults on Medicare making these insurance decisions has also continued to grow as the population ages. On an average day in the Dayton region, about 53 percent of hospital patients are paying with Medicare.

Medicare Advantage plans, which are run by private insurance companies, get a fixed rate from the federal government each month for each person they enroll.

These privatized Medicare plans are serving a record number of people this year — about one third of Medicare’s total 59 million members.

Premier Health will stop operating its Medicare Advantage plans effective April 1 and Medicare Advantage members with those plans who do not enroll in another plan before April 1 will be automatically enrolled in traditional Medicare and SilverScript, a prescription drug plan.

Starting April 1, members who are auto-enrolled in traditional Medicare and SilverScript will still have until May 31 to shop and switch to another plan.

Reeg said the state is keeping busy helping residents understand their options because there are trade offs to Medicare and Medicare Advantage.

Medicare Advantage plans typically include drug coverage and most have extras like dental and vision. But Medicare Advantage plans also have limited networks compared to traditional Medicare, which lets seniors go to whatever hospital or doctor they want.

RELATED: Sale of Premier Health’s insurance line falls apart

While there are a host of other Medicare Advantage plans vying for customers, Reeg emphasized that former Premier insurance customers can also always go back to traditional Medicare if that seems like the best option.

Reeg said seniors need to consider what kind of costs are associate with plans, what kind of coverage each plan will give them and how convenient health care will be with each plan.

“We always go back to the three C’s: cost coverage and convenience,” she said.

State residents can get free information about their options from the Ohio Senior Health Insurance Information Program at 1-800-686-1578.

“Our phone lines have definitely picked up. Our counseling appointments in that area have definitely picked up,” Reeg said.

RELATED: High Medicaid, Medicare use in Dayton increases health care costs

Rick Dunlop, UnitedHealthcare’s Medicare CEO of Ohio, said his company has about 80,000 Medicare Advantage members in the state and in about 30,000 in southwest Ohio.

“We’re seeing the numbers increase pretty significantly,” he said.

UHC had more than 6,200 Medicare Advantage policy holders in Montgomery County as of March but expects those numbers to grow because of new customers coming from Premier.

Dunlop said part of the appeal that they promote is that Medicare Advantage looks and feels like employer-based coverage and feels familiar to people just coming out of employment and into retirement. There numbers are also being boosted by an aging population in general and people interested in benefits like pharmacy instead of having to buy a separate part D plan.


PREVIOUSLY: Premier Health previously announced it was discontining its Medicare Advantage plans.

WHAT'S NEW: Insurance companies are scrambling to attract seniors to their Medicare Advantage plans before the deadline.

WHAT'S NEXT: Starting April 1, members who don't pick a new plan will be auto-enrolled in traditional Medicare and the final deadline to pick a new Medicare plan is May 31. For free information about options from the Ohio Senior Health Insurance Information Program call 1-800-686-1578.

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