Many seniors in Stanislaus County are confronted with dropping their insurance coverage protection Aug. 1 due to the monetary troubles of a Medicare well being plan.
The Golden State Medicare Well being Plan despatched letters close to the tip of June notifying members its contract with Medicare was being mutually terminated efficient Aug. 1. Individuals enrolled with Golden State will lose their insurance coverage Aug. 1. Seniors lined by different insurance coverage should not affected.
The state Division of Managed Well being Care took motion final 12 months to revoke Golden State’s well being plan license based mostly on the insurance coverage plan’s deteriorated monetary situation.
In line with a settlement settlement with the state company, which governs managed-care protection in California, Golden State reported a $27 million deficit in an April 2021 monetary assertion and a $35 million deficiency in December. A Division of Managed Well being Care order in April 2021 prohibited Golden State from accepting new functions for enrollment.
Golden State has offered insurance coverage for Medicare recipients in Stanislaus, San Luis Obispo, San Francisco counties and 5 counties in Southern California.
“We’re getting loads of calls from these folks,” mentioned Maria Profeta, program supervisor for the Well being Insurance coverage Counseling and Advocacy Program in Stanislaus County.
Profeta mentioned the HICAP workplace, which helps folks navigate the Medicare system, is making 10 or extra appointments per week to assist them join different insurance coverage protection. Ten different insurance coverage carriers supply federally backed “Medicare Benefit” well being plans in Stanislaus County.
A consultant for Golden State of Newport Seaside couldn’t be reached Wednesday. A cellphone recording mentioned the well being plan will stop to exist efficient Aug. 1 and suggested members to name the Medicare program or go to the Medicare.gov web site to acquire different insurance coverage.
The Modesto HICAP workplace didn’t have a rely on Golden State’s membership in Stanislaus County.
Profeta mentioned Golden State purchasers who don’t make adjustments might lose prescription drug protection and can revert in August to unique Medicare advantages, which don’t cowl full price of hospitalization, Profeta mentioned.
“It might be troublesome to see a physician, as a result of many docs don’t work with unique Medicare,” she added.
Along with the Modesto HICAP workplace, this system giving unbiased assist to Medicare recipients has satellite tv for pc areas in Turlock, Ceres, Oakdale and Patterson. Individuals in outlying communities might name HICAP to make appointments for help at satellite tv for pc areas. HICAP additionally has counseling appointments by cellphone or video conferencing.
The HICAP program will maintain an enrollment occasion on Aug. 18 from 8 a.m. to 11 a.m. on the Stanislaus County library, 1500 I St., in Modesto. The Modesto Farmers Market additionally will happen throughout that point. Representatives of varied insurance coverage will reply questions on their authorized Medicare plans.
Golden State started serving members in Stanislaus County in 2015. It supplied protection at zero premiums and no copayments for inpatient hospital and physician visits.
The Well being Insurance coverage Counseling and Advocacy Program in Stanislaus County may be reached at 209-558-4540. The toll free quantity for Medicare is 800-633-4227 or go to Medicare.gov.
This story was initially revealed July 21, 2022 6:00 AM.