Care1st insurer to drop Medicare plan in Stanislaus County

The federal Medicare program has an enrollment window in the fall for seniors and other beneficiaries to make changes in health coverage.

This year’s enrollment period runs from Saturday through Dec. 7, allowing people to review their health and drug coverage and make adjustments for 2017.

In Stanislaus County, more than 1,800 residents will be affected as Care1st discontinues its Medicare Advantage plan next year. Care1st will offer a plan for county residents who are dually eligible for Medicare and the state’s Medi-Cal program for the poor.

Those enrolled in Care1st Advantage Optimum will need to switch to another insurer for Medicare Advantage coverage, which provides benefits for physician visits, hospitalization, prescription drugs and other services on top of basic Medicare, said Maria Profeta, program manager for the Health Insurance Counseling and Advocacy Program in Modesto.

County residents will still have a choice of seven insurers that offer Medicare Advantage plans. The premiums range from zero to more than $160 a month.

The HICAP office will hold forums this month in Modesto, Turlock, Oakdale and Patterson to provide information on 2017 benefits and costs of Medicare health plans. Medicare is the national health program for seniors age 65 and older and adults with certain disabilities.

Anthem Blue Cross is introducing a special-needs plan for people with end-stage kidney disease. Those patients are eligible for basic Medicare benefits but cannot enroll in extra Medicare Advantage or Medigap insurance, Profeta said. The special-needs plan will have benefits tailored for renal-failure patients.

Anthem will discuss the details at HICAP’s forum at the Modesto Senior Center on Oct. 27. HICAP counselors can provide information on the preferred provider plan during the enrollment period.

“We have a great need for that,” Profeta said. “We have quite a few people on dialysis.”

Profeta said changes also are in store for some zero-premium Medicare Advantage plans in 2017.

No one expects an increase next year in the Medicare Part B monthly premium for outpatient care, after the cost leaped from $104.90 in 2015 to $121.80 this year.

This story was originally published October 12, 2016 at 2:49 PM with the headline "Care1st insurer to drop Medicare plan in Stanislaus County."