KAILUA-KONA — Some Kaiser Permanente patients on Medicare were worried Monday after receiving official documents that left them with the impression they were losing coverage.
But their coverage will continue.
The confusion is largely the result of the government letters notifying people of a change in the program having reached people before Kaiser’s letters, wrote Laura M. Lott, director of communications and public relations for Kaiser Permanente Hawaii.
“The (Centers for Medicare and Medicaid Services) letter sent to seniors is very technical and not exactly ‘user friendly.’ We’ve received many calls and want to make sure our seniors know that information is coming and all existing Kaiser Permanente members will be offered the ‘new’ plan so they can continue to see their same doctor and receive the same high-quality care and services at the same locations.”
The change will reduce the two current plans, “Essential” and “Essential Plus,” to one called “Senior Advantage Hawaii Island,” which goes into effect Jan. 1, 2017.
It will affect 3,945 people currently on the island, Lott wrote.
“Unfortunately, the federal government does not allow us to make significant changes to an existing plan. The Centers for Medicare and Medicaid Services regulations require us to dis-enroll members from the existing Medicare plan and offer a ‘new’ plan,” she wrote.
The letters from CMS already arrived, but the new plan information is expected to come to those patients affected at the end of the week.
“We are concerned that this lag time may cause confusion for some seniors,” Lott wrote. “It is unfortunate, but CMS rules prevented us from communicating about the new plans with members in advance of CMS notification Oct. 1, 2016.”
Thomas Hackett was one of the people caught off guard by the letter, which stated “Your Medicare plan won’t be offered in 2017 … Kaiser Permanente is an HMO plan with a Medicare contract. Enrollment in Kaiser Permanente depends on contract renewal.”
“My wife and I are 67 years old and living in Ocean View for the past six years,” Hackett wrote. “Kaiser has been in the news lately for the Maui Hospital transition. But I have not heard anything about the cessation of coverage here.”
Members on Maui and the Big Island have to re-enroll because of Medicare rules. It is entirely up to the patients if they re-enroll with Kaiser Permanente, Lott said, “although we hope they re-enroll.”
Lott referred people to the Hawaii Island Kaiser Permanente website at kp.org/medicare/hawaiiisland. It includes information about the plan changes, documents and needed paperwork. Additionally, Kaiser can be reached by calling 1-800-805-2739 from 8 a.m.-8 p.m. seven days a week.
There will be town hall meetings in Hilo, Kailua-Kona and Waimea for people who have questions about the new plan.
Hilo meetings are slated for 9 a.m., noon and 3 and 5 p.m. Oct. 17 and 9 and 11 a.m. and 2 p.m. Oct. 18 at the Hilo Hawaiian Hotel.
Kailua-Kona meetings are scheduled for 9 a.m., noon and 3 and 5 p.m. Oct. 19 and 9 a.m., noon and 2 p.m. Oct. 21 at the Royal Kona Resort. Meetings in Waimea are set for 10 a.m. and 1 p.m. Oct. 20 at the Anna Ranch Heritage Center.
The changes come as the result of the fact premiums, co-pays and Medicare reimbursement don’t adequately cover the cost of providing the various services, Lott wrote.
The new plan will have a $194 premium compared with the $63 of the Essential and the $202 Essential Plus plans.
“We know that these changes may be difficult for some seniors, so there are financial assistance programs,” Lott wrote. “Given the rising cost of medical care and drugs and Medicare reimbursement rates these changes are necessary. We want to be here to care for all our members for many years to come. To do that, we have to be financially stable.”
Email Graham Milldrum at gmilldrum@westhawaiitoday.com.
