Seniors to pay more for less health coverage

Friday, October 16, 1998

The Cincinnati Enquirer

About 47,000 Ohio seniors -- including people in Hamilton, Butler and Warren counties -- will pay more for weaker health coverage to prevent Anthem Blue Cross and Blue Shield from dropping about 7,000 people from its Medicare HMO.

It's part of a compromise approved Thursday by the Health Care Financing Administration (HCFA), the agency that runs Medicare, to soothe the sting of Anthem's original plan to drop 20,000 seniors in 19 counties and parts of three others.

After taking heat from enrollees and politicians, Anthem agreed to continue offering its Senior Advantage Medicare HMO to about 7,000 people in six counties (Brown, Darke, Greene, Miami, Preble and Shelby) and parts of three others (Warren, Madison and Columbiana). Anthem will still drop 13 counties as of Jan. 1.

But because HCFA refused to increase Anthem's reimbursement rate -- the reason for the pullout -- the company is charging more to enrollees and cutting some benefits.

Letters informing enrollees of their benefit changes go out in the next few days.

Seniors in Warren and Butler counties will become part of a new Dayton region. They will be charged $39 monthly premiums (up from no charge); $300 co-payments for hospital stays (up from no co-payment); $10 for doctor visits instead of $5; and $50 for emergency room visits instead $25. Prescription benefits will be cut to $500 a year, down from $1,000.

This may be a shock for Butler residents because they were not affected by the original pullout decision but have been moved into Anthem's Dayton region, where the benefits are lower and costs are much higher than in Cincinnati.

In the Cincinnati region, including Hamilton, Clermont and Brown counties, seniors will keep their $0 premium and $5 office visits, but their drug benefit drops to $900 a year and their emergency room visits bump to $50.

Local Headlines For Friday, October 16, 1998

Special Coverage: CLINTON UNDER FIRE
"Asia for Kids' catalog spans globe
"Godspeed, John Glenn . . . and, uh, the rest of you'
3 motives surface in strangulation
Acting chief put on leave over racial slurs
Area author compiles "Canine Crimes'
Black doctors get hearing on HMO concerns
Boyle attacks Voinovich on education
Candidates gird for late TV push
CPS: State audit partly unrealistic
Denying gays equal rights shames us all
Driver gets 43 years for crashes
FOP endorses Murgatroyd
Franklin teens deny bomb threat
Glen Este, Amelia get auditoriums
Grant birthplace celebrates designation to National Register
Halloween haunts, fall family festivals
Hundreds mourn gay victim
Kids' character counts
Landfill ruling in panel's lap
Methadone clinic site flexible?
NBC saves bad shows for last
No school immune to violence, panel warns
Obituary: John Schiff
Parking study favors river site
Princeton player sent to prison
Same evidence, three verdicts
Seniors to pay more for less health coverage
Sycamore voters asked to OK two tax hikes
Teacher accused of sex abuse
Technology windfall awaits school
Trustee opposes extending Reagan Highway
TV ad touts riverfront stadium
Words key to Corporex settlement