Premiums will increase for some Medicare plans in Stanislaus County

Some Medicare beneficiaries in Stanislaus County will pay higher premiums for their managed-care plans next year.

An enrollment period continuing through Dec.7 allows seniors in the national health program to make changes to their medical and prescription drug coverage for 2015. Many county residents are enrolled in Medicare Advantage plans that provide coverage and services not included in the traditional Medicare program.

The monthly cost for the AARP-Secure Horizons Medicare Advantage plan will be $99 starting Jan.1, up from $89 this year. Secure Horizons offers a second plan with no monthly premium, though it may not provide as many services and the co-payments are higher.

Care 1st Advantage Optimum, which previously charged no monthly premium, will cost $45 a month next year and require a $150 daily co-payment for the first five days of hospitalization.

Humana will charge $58 a month for its most expensive plan in Stanislaus County, an increase from $42. Those costs are on top of the $104.90 monthly premium for Medicare Part B, which won’t change in 2015.

Two plans are lowering their premiums: HealthNet Healthy Heart from $169 to $162 a month, but with higher co-pays for hospitalization; and Kaiser Senior Advantage Enhanced from $75 to $72 a month, also with increased co-pays for hospital stays.

Next year, there is no monthly premium for CareMore StartSmart Plus, Citizens Choice, Easy Choice and Humana Gold Plus basic. Kaiser Senior Advantage Basic will cost $10 a month and CareMore Value Plus will be $49 a month.

In September, the federal Centers for Medicare & Medicaid Services projected that Medicare Advantage enrollment would hit a record high in 2015 and remain affordable, despite concerns about higher costs tied to the Affordable Care Act of 2010. The average premium is projected at $33.90 a month, or $2.94 more than this year, though the average increase could be $1.30 when accounting for people opting for lower-cost plans.

About 60 percent of seniors will not see a premium increase, the government agency said.

Thirty percent of Medicare recipients, or 15.7million Americans, were enrolled in Medicare Advantage plans this year to insure themselves for events not fully covered by the national health program for seniors 65 and older.

Traditional Medicare covers 80percent of allowable costs for medical care and has a $1,260 annual deductible for hospital stays. Patients who have no extra coverage will amass a huge bill if they are in the hospital for more than two months with a catastrophic illness.

Eight insurers have government approval to offer the subsidized plans in Stanislaus County. The county’s Health Insurance Counseling and Advocacy Program held informational meetings last month in Modesto, Turlock, Oakdale and Patterson to provide help with comparing plans.

Sandy Howell, an insurance counselor for HICAP, said the plans with no monthly premium typically make customers responsible for higher co-payments. Those enrolling in Medicare Advantage plans are required to have a primary care doctor and are served by physicians and hospitals that contract with the health plan.

Seniors who may want to switch to a different plan should make sure they can continue to see their doctors and that the plan covers their medications.

The plans include prescription drug, dental and vision coverage, and provide for emergency or urgent care for customers traveling outside the country.

The HICAP office, at 121 Downey Ave. in Modesto, offers free assistance for people trying to navigate the Medicare system. It is open weekdays from 8:30 a.m. to 4:30 p.m. Call (209)558-4540.

This story was originally published November 6, 2014 at 12:11 PM with the headline "Premiums will increase for some Medicare plans in Stanislaus County."