Universal Health Care shutdown to affect about 900 seniors in region

Health care reform

Health care reform

— Nearly 900 elderly Southwest Florida residents who have Medicare Advantage coverage with Universal Health Care need to switch to a new managed-care plan or accept traditional Medicare.

The St. Petersburg-based Universal Health Care was ordered into receivership for purposes of liquidation two weeks ago. All Universal policies are canceled as of today, according to the state Agency for Health Care Administration.

All told, Universal has 40,000 Medicare members statewide, with 349 enrollees in Collier County and 554 enrollees in Lee County, according to the federal Centers for Medicare & Medicaid.

Another 57,000 Medicaid clients in Florida have been enrolled in Universal’s managed-care plan but none of them live in Lee or Collier counties, according to state agency spokeswoman Michell Dahnke.

Seniors who haven’t acted by today are automatically enrolled by the federal government in traditional Medicare, according to the Centers for Medicare & Medicaid.

But those seniors also will have a special election period to change to another managed-care plan, and that special election period is from now through May 31.

What seniors need to understand is that their new policy won’t take effect until the first of the month after they make a plan change. For example, changes received in April won’t take effect until May 1, according to the federal agency.

What’s concerning to local physician practices is that Universal Advantage enrollees may not understand they need to be proactive and switch if they want to be in another managed-care plan with the same benefits as they had with Universal, said Brandy Church, spokeswoman for Milliennium Physician Group, which has 80 doctors’ practice locations throughout Southwest Florida.

Patients who see Millennium physicians can switch to Medicare managed care plans offered by Humana, Aetna, Blue Shield, Freedom Health, or United Healthcare, all of which are under contract with Millennium, Church said.

Millennium offices this past week fielded calls because notices of the liquidation of Universal had just gone out, she said.

“It’s tough to estimate how many, with so many of the patients speaking directly to staff, but I would estimate almost every Universal patient has questions about if they can still see their doctor after April 1,” she said.

The federal Medicare & Medicaid office put out an advisory that says the federal government is committed to helping beneficiaries understand what is happening with their benefits in the short and long term.

The federal agency “will transition all affected Universal enrollees to original Medicare, and into a comparable prescription drug plan, for those who had prescription drug coverage under Universal, effective April 1,” according to the Centers for Medicare & Medicaid.

Balford L. Francis, director of managed care and network development for Millennium, said patients are calling with concerns about staying with their primary care doctors, their out-of-pocket expenses and if other plans will reward them for maintaining good health.

“All Medicare (Advantage) plans offer a standard Medicare benefit package that may or may not include drug coverage based on the type of plan,” he said. “However, one of the appealing factors of Medicare Advantage plans is the flexibility to provide additional benefits such as reimbursement for maintaining good health.”

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