Critical Condition

Mass. Insurer Abandons Medicare Advantage

Remember those Andy Griffith Medicare ads suggesting that retirees wouldn’t lose their benefits? The Boston Globe is reporting that Harvard Pilgrim Health Care, the second-largest health insurer in Massachusetts, has decided to entirely drop out of the market-oriented Medicare Advantage program (h/t Drudge):

Harvard Pilgrim Health Care has notified customers that it will drop its Medicare Advantage health insurance program at the end of the year, forcing 22,000 senior citizens in Massachusetts, New Hampshire, and Maine to seek alternative supplemental coverage.

The decision by Wellesley-based Harvard Pilgrim, the state’s second-largest health insurer, was prompted by a freeze in federal reimbursements and a new requirement that insurers offering the kind of product sold by Harvard Pilgrim — a Medicare Advantage private fee for service plan — form a contracted network of doctors who agree to participate for a negotiated amount of money. Under current rules, patients can seek care from any doctor.

We became concerned by the long-term viability of Medicare Advantage programs in general,” said Lynn Bowman, vice president of customer service at Harvard Pilgrim’s office in Quincy. “We know that cuts in Medicare are being used to fund national health care reform. And we also had concerns about our ability to build a network of health care providers that would meet the needs of our seniors.”

Readers will recall that the largest source of funding for Obamacare was eliminating $548 billion of funding for privately managed Medicare Advantage plans. Harvard Pilgrim will route its Medicare Advantage customers back into traditional, government-run Medicare, and seek to offer them “Medigap” plans, supplements that lack prescription drug coverage:

Harvard Pilgrim in a second mailing this week will urge customers to switch to a new Medicare Supplement plan it will begin offering in October. Unlike Medicare Advantage, which is overseen by the Centers for Medicare and Medicaid Services, the new Harvard Pilgrim plan will be overseen by the Massachusetts Division of Insurance.

It will be “slightly more expensive’’ than the Medicare Advantage plans, but competitive with supplemental insurance plans offered by rivals such as Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer, Bowman said.

She said the Medicare Supplement plan will feature some benefits not covered by the current plan, such as fitness reimbursements, but won’t pay for prescription drugs, which are covered by some versions of the current plan. Instead, seniors can buy separate supplemental drug coverage through a partnership with Coventry Health Care, in Bethesda, Md.

Avik Roy is an equity research analyst at Monness, Crespi, Hardt & Co., and blogs on health-care policy at The Apothecary.

Avik RoyMr. Roy, the president of the Foundation for Research on Equal Opportunity, is a former policy adviser to Mitt Romney, Rick Perry, and Marco Rubio.

Most Popular

U.S.

A Data Double Take: Police Shootings

In a recent article, social scientist Patrick Ball revisited his and Kristian Lum’s 2015 study, which made a compelling argument for the underreporting of lethal police shootings by the Bureau of Justice Statistics (BJS). Lum and Ball’s study may be old, but it bears revisiting amid debates over the American ... Read More
U.S.

A Data Double Take: Police Shootings

In a recent article, social scientist Patrick Ball revisited his and Kristian Lum’s 2015 study, which made a compelling argument for the underreporting of lethal police shootings by the Bureau of Justice Statistics (BJS). Lum and Ball’s study may be old, but it bears revisiting amid debates over the American ... Read More

How Many Jeffrey Epsteins Are There?

Goodman Brown was a young, pious man, from a family of “honest men and good Christians since the days of the martyrs,” when he first discovered that the society around him was full of evil hiding in plain sight. Brown, the main character of Nathaniel Hawthorne’s 1835 short story “Young Goodman Brown,” ... Read More

How Many Jeffrey Epsteins Are There?

Goodman Brown was a young, pious man, from a family of “honest men and good Christians since the days of the martyrs,” when he first discovered that the society around him was full of evil hiding in plain sight. Brown, the main character of Nathaniel Hawthorne’s 1835 short story “Young Goodman Brown,” ... Read More
Culture

How Long Will Margaret Sanger Last?

Much of the radical Left is at present consumed by a feverish desire to erase from U.S. history anyone whom they’ve deemed in some way insufficiently loyal to the progressive creed of 2020. The statue-toppling brigades have exercised little discretion in determining which of our leaders are no longer fit for ... Read More
Culture

How Long Will Margaret Sanger Last?

Much of the radical Left is at present consumed by a feverish desire to erase from U.S. history anyone whom they’ve deemed in some way insufficiently loyal to the progressive creed of 2020. The statue-toppling brigades have exercised little discretion in determining which of our leaders are no longer fit for ... Read More