Left with few alternatives, Mineral Co. patients consider health - KPAX.com | Continuous News | Missoula & Western Montana


Left with few alternatives, Mineral Co. patients consider healthcare options

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(Editor's note: This report is specifically about insurance options that Medicare Advantage Plan patients in Mineral County have now that Blue Cross Blue Shield announced that they are withdrawing from the Medicare Advantage Plan market in some Montana counties. This report is only about Medicare Advantage Plan patients, multiple insurance companies may be selling other types of products in those counties.)

SUPERIOR - When Blue Cross Blue Shield announced in October that they were withdrawing from the Medicare Advantage Plan market in all but nine Montana counties, it left rural hospitals and patients scrambling to figure out a solution.

Blue Cross Blue Shield dropped all of their Medicare Advantage Plan patients in 30 Montana counties, effective January 1. This gave hospitals just three months to contract with another insurance company that would offer Advantage plans to their patients. 

It hasn’t happened yet in Mineral County at Mineral Community Hospital, and patients like Sue McLees are having to make tough decisions.

“There were rumors, and then we got the letter that said 'we are no longer going to cover you,'" McLees said. "And then we said 'OK, now what?”

McLees lost her insurance coverage and is now weighing her options. She’s considering Humana, an insurance company that just stepped onto the scene to sell Medicare Advantage Plans to people in Mineral County. But Humana does not yet have a contract with the local Mineral Community Hospital.

The two are in negotiations with a group of other rural hospitals that were just dropped by Blue Cross Blue Shield. Monida Healthcare Network is negotiating the contract.

Monida Executive Director Greg Drapes said they received a contract in mid-November.

Humana declined to comment on the on-going negotiations. Humana said in a statement that they are offering three Medicare Advantage plans in Mineral County.

"If a Mineral County member is experiencing a true emergency, treatment at any emergency room will be covered at the in-network benefit level under certain conditions," their statement said.

But without a local contract, patients are looking at having to drive to Missoula or Polson for care where the closest in-network providers are currently located.

If people choose to not purchase another Medicare Advantage Plan, they do have options, according to Mineral Community Hospital CEO Ron Gleason. They could go onto regular Medicare and purchase a supplement, along with parts B and D that are recommended.

“Your supplements, for most of us, are fairly expensive," McLees said. "I would say $120, $200-a-month. But you don’t have your co-pays and things like that. But your advantage plans have actually covered pretty well for me.”

McLees says the Medicare Advantage Plan is less expensive for her.

Besides considering the costs, she is also looking at driving a long distance to keep her advantage plan if Humana does not secure a contract with Mineral Community Hospital.

Patients like McLees have a very short period of time to weigh the costs, the distance, and the coverage options, without knowing whether or not they will be able to go to their local hospital for their care.

Humana said that the Medicare Annual Enrollment Period is open until Dec. 7.

Montana residents who have received a letter of coverage termination from their current insurance carrier are eligible for an extended special election period that allows for enrollment through Feb. 28, 2018.

However, for those wanting coverage on January 1, a selection must be made before the end of this year, they said.

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