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Saturday, June 3, 2000

Straub sheds
senior care

About 1,100 seniors will
lose out when the 'Medigap'
coverage is dropped June 30

Kaiser Permanente, HMSA keeping
plans for Hawaii's seniors

By Peter Wagner


Citing dwindling membership and rising costs, Straub Health Plan Services plans to drop its "Medigap" supplemental insurance currently held by about 1,100 senior citizens.

The Senior StraubCare Plan, which pays for costs not covered by Medicare, is to be discontinued June 30, the provider confirms.

Letters sent to subscribers by Straub last week say a 1988 change in federal medical insurance laws led to dwindling enrollment.

Straub Health Plan Services is a department of PhyCor Inc., the affiliate of Straub Clinic and Hospital based in Nashville, Tenn.

Straub spokeswoman Ann Nishida said membership in StraubCare, established in 1986, has dropped nearly 50 percent since 1993.

Congress in 1988 enacted the Medicare Catastrophic Coverage Act, an attempt to bring order to the proliferating number and types of health insurance plans.

The law restricted Straub from accepting new members unless it agreed to extend coverage to competing medical providers, a step it didn't want to take, Nishida said.

Enrollment has therefore dwindled by attrition over the years, making administration costs unfeasible, she said.

Straub's Medigap plan, which costs $70 a month, insures beyond the 80 percent to 85 percent coverage provided for a variety of medical services by Medicare.

William Jefferies, a 77-year-old Kailua resident, was chagrined to learn by letter May 26 his StraubCare Plan would be terminated.

"What bothered me more than anything about this was there were no public announcements and nobody heard a word about it," he said. "To me it's kind of cavalier the way they handled things."

Jefferies joined the plan when he retired from Hawaiian Electric Co. in 1990.

He said Heco is currently trying to arrange alternate Medigap coverage for its retirees.

Letters to subscribers listed a number of Medigap alternatives available in Hawaii. And Straub plans to conduct an informational meeting for StraubCare members.

Kaiser Permanente,
HMSA keeping plans
for Hawaii’s seniors

By Helen Altonn


Island Medicare beneficiaries don't have to worry about losing their coverage from health maintenance organizations, Hawaii health care officials said today.

"I really don't see happening in Hawaii what's happened on the mainland," said Richard E. Meiers, president and chief executive officer of the Healthcare Association of Hawaii.

The two major insurers here for Medicare are Kaiser Permanente and the Hawaii Medical Service Association, and a few others may be involved with the state's QUEST program, Meiers said. If one should pull out, he feels the clients would be picked up immediately.

Cliff Cisco, HMSA senior vice president for communications, said the federal Health Care Finance Administration anticipated a number of mainland HMOs would pull out of Medicare.

They must give notice by June 30 if they want to continue Medicare participation in 2001, he said. Cisco said HMSA and Kaiser are the only insurers here in the Medicare business with HCFA contracts and that HMSA doesn't intend to withdraw. It has two senior health plans.

Kaiser Permanente also has no plans to cut back its senior plans, said Chris Pablo, manager of the system's public, government and community affairs. "It's terrible that those HMOs are pulling out on the mainland, but it is due in part to the reimbursement level," Pablo said, pointing out that companies must have "a mixture of risks" to absorb the losses.

"The reimbursement level, for hospitals particularly, is not fair. For Hawaii ... reimbursement levels don't reflect the actual cost."

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