Summit County’s largest Medicare managed-care insurer is expanding and changing the names of its plans in 2014 but keeping most of the benefits the same.
SummaCare will market three Medicare Advantage managed-care plans to seniors and other eligible Medicare recipients in 41 counties throughout the northern half of Ohio, according to information released today by the insurer.
The Akron insurance company is selling the optional Medicare plans in 18 new counties in the Toledo-Lima region next year, said Jim Loveless.
The expansion is because of Summa Health System’s new partnership with HealthSpan Partners, an auxiliary of Catholic Health Partners, he said. Catholic Health Partners operates hospitals in those areas.
“Now we’re in all of northern Ohio,” Loveless said. “When we look to do expansions, it’s really tied to the partnerships we’ve built.”
The federal government contracts with private insurers to offer Medicare Advantage managed-care plans, which provide enrollees help paying for doctor visits, hospital stays and other medical services.
Medicare managed-care plans also will be offered in Summit County next year by Aetna, Anthem, UnitedHealthcare, PrimeTime Health Plan, The Health Plan, HealthSpan (formerly Kaiser Permanente), Humana, Gateway Health and WellCare, according to the Centers for Medicare and Medicaid Services.
Many of the plans — including SummaCare’s offerings for next year — also include Medicare Part D prescription drug coverage.
Open enrollments for Medicare Part D prescription drug plans and managed care plans begin Oct. 15 and continue through Dec. 7.
In Summit County, 45,820 of the more than 98,600 Medicare recipients are enrolled in a Medicare managed-care plan, according to data from the Centers for Medicare and Medicaid Services. More than 15,400 Summit County residents are currently enrolled in one of SummaCare’s Medicare managed-care plans.
All three SummaCare plans continue to cover primary-care office visits and preferred generic medications at no cost to enrollees for next year, Loveless said.
In 2014, SummaCare will offer a “Ruby” plan for $0 per month, a “Sapphire” plan for $65 per month and an “Emerald” option for $165 per month.
Participating managed-care companies get monthly payments from the federal government in addition to the premiums charged to enrollees to cover costs.
This year, SummaCare is charging consumers $0 for the Core plan, $43 for the Silver plan and $134 for its Gold plan.
SummaCare is increasing the monthly premiums for two of the plans to cover rising medical costs and reductions in payments from the federal government, Loveless said.
The names of SummaCare’s Medicare plans are changing from Core, Silver and Gold to avoid confusion with the new “Obamacare” Health Insurance Marketplace plans, which use medal designations to denote coverage levels, Loveless said. “We’re trying to eliminate confusion.”
The annual Medicare open enrollment period is separate from the recently launched Health Insurance Marketplace, created under the federal health-reform law as a way for consumers and small businesses to shop for insurance and apply for potential federal subsidies to buy coverage.
More information about available Medicare plans for 2014 can be found online at www.medicare.gov.
Cheryl Powell can be reached at 330-996-3902 or firstname.lastname@example.org. Follow Powell on Twitter at twitter.com/abjcherylpowell.