Queen’s to offer
Medicare plan

By Russ Lynch
Star-Bulletin

Queen's Health Plans is teaming up with a mainland health insurance company to set up a health maintenance organization for Medicare patients.

The island health plan, a subsidiary of the Queen's Health System, said today it will have a franchise agreement with Secure Horizons USA, the Medicare health plan arm of Santa Ana, Calif.-based PacifiCare Health Systems Inc. The plan is subject to federal approval.

The arrangement, planned to start early next year, would give Medicare patients increased benefits and reduce the fees they might have to pay to supplement the payments by the federally funded program for those over 65.

"We are joining them to get their expertise," said Dr. John Morris, chairman and chief executive of Queen's Health Plans.

Morris said Medicare HMOs are the move of the future and Hawaii's health care providers are heading that way as they compete for the business of about 150,000 residents who are eligible.

But plan management is risky, because individuals can change their medical services provider every month. That's where experts such as Secure Horizons come in, Morris said.

Medicare, which is funded out of Social Security, pays most of the cost of health services for the over-65 age group, although there are some deductibles and residents of some areas may have to pay part of the cost, he said.

While Morris said it is too early to say just what gains those in the HMO might make, officials at Secure Horizons gave examples of what was achieved in Southern California. Medicare requires users to pay the first $100 of annual medical costs, does not pay for annual physicals or eyesight or hearing examinations, and has limited hospitalization coverage. Secure Horizons' Medicare HMO has no deductible, provides free annual exams and unlimited hospitalization, the company said.

Queen's Health Plans cover 175,000 civilian and military residents of Hawaii.