There are a handful of 2017 Medicare Advantage plan disruptions that senior market agents should be aware of.
Starting next year, Aetna MA members will no longer have in-network access to providers in the Rochester Regional Health system. Additionally, New West Health Services will be closing its doors at the end of this year.
Read more about the plan disruptions below.
Aetna and Rochester Regional Health Fail to Reach MA Agreement
Rochester Regional Health announced it was unable to reach an agreement with Aetna for MA for the upcoming year for Rochester General Hospital, Unity Hospital, Newark-Wayne Community Hospital, and the physicians affiliated with those hospitals. As a result, the hospitals and their affiliated physicians will be considered out-of-network for Aetna MA members effective January 1.
Aetna has sent mailings about the upcoming network change to its Rochester-area MA members. It has also sent letters about the change to its MA members who have had claims with the affected hospitals or physicians within the past year.
Approximately 7,000 Aetna policyholders go to the affected Rochester Regional Health hospitals and doctors. Those who wish to continue to do so will have to pay higher copays and out-of-pocket costs for going out-of-network or switch to a different carrier that has the system in its MA network while they can.
Rochester Regional Health has full contracts with Excellus BlueCross BlueShield and MVP Health Care for Medicare Advantage members in Monroe and Wayne counties.
New West Health Services to Close in 2017
New West Health Services, an insurer based in Montana, recently announced that it will be ceasing all operations next year due to financial losses.
The insurer will continue to provide its 14,000 MA members the same benefits and services through the end of the year. If members do not select a new MA plan before then, they will be returned to Original Medicare on January 1. The company’s 1,000 Med Supp members may be transferred to another insurer.
New West Health Services currently offers MA plans in 25 Montana counties and Med Supp plans statewide. After the company closes, Blue Cross and Blue Shield of Montana and Humana will be the only companies offering MA in Flathead County.