Health care • No coverage gap, but enrollees face a coverage deadline and could pay more.
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About 1,100 Utah seniors enrolled in Universal Health Care's two Medicare Advantage plans have until May 31 to pick a new managed-care policy.
Otherwise, they'll revert to traditional Medicare and possibly face higher-out-of-pocket costs, say state officials who urge displaced enrollees to research their options and act soon.
Florida-based Universal Health Care Insurance Co. was court ordered into receivership, which means the state of Florida will take control of the company for purposes of liquidation, according to the U.S. Centers for Medicare & Medicaid Services (CMS).
Precisely what led to the company's insolvency isn't clear, said Darren Hotton with the Utah Division of Aging and Adult Services. "One of the marketing and selling points of this plan was [Universal's] promise to pay a portion of enrollees' premiums. … They obviously got enough clients, but not enough revenue to pay claims."
There will be no gap in coverage for Universal Health Care clients. Effective April 1, they automatically will be enrolled in traditional Medicare, according to CMS. Clients with prescription drug coverage will be enrolled in a comparable drug plan.
Beneficiaries will receive a notice in the mail explaining the changes. They will be able to continue seeing their current providers, say CMS officials, and there will be no interruption in care for those in skilled nursing care.
But the change could hit their pocketbooks, said Hotton. "It could cost them more, or less, depending on what kind of health care they're needing."
That's because Advantage plans run under a copay system with enrollees paying a small amount for office visits upfront. Traditional Medicare, on the other hand, has no copay but covers only a portion of the total bill, typically 80 percent.
Beneficiaries can pick another Advantage plan and drug plan. They have 60 days to make a switch.
And they should know that coverage won't kick in until the first day of the following month; on May 1 for those who switch in April.
Most of those affected in Utah live in Washington County, says Hotton, who urges seniors to explore their options with Aging Services' insurance counselors at (800) 541-7735.
"If they have drug coverage, they need to make sure their drugs are still covered," said Hotton. "They should also ask their doctor which plans they actively participate in."
The disruption is unfortunate but has hit other states much harder, he added. "For people who weren't happy with their Advantage plan or drug plan, it's an opportunity to make a change outside of the regular enrollment period."
For more information, call 1-800-MEDICARE.
Find out if you're affected
o Utahns affected by Universal Health Care's closure can learn more by calling 1-800-MEDICARE.
For information about coverage options, including special rights to purchase a Medigap policy and assistance paying Medicare premiums, deductibles and coinsurance, seniors should contact the Department of Aging and Adult Services at 800-541-7735 or 801-538-3910.