Zero-premium Geisinger Health Medicare Advantage Plans are being dropped in Pike County, affecting over 700 people, mostly senior citizens, said Alicia Bonnadonna, Pike County’s APPRISE Coordinator.
MILFORD - Zero-premium Geisinger Health Medicare Advantage Plans are being dropped in Pike County, affecting over 700 people, mostly senior citizens, said Alicia Bonnadonna, Pike County’s APPRISE Coordinator.
The popular plan, which doesn’t cost the beneficiary anything and yet carries hospitalization, medical and prescriptions, will still be available in Wayne County.
In her role, Bonnadonna leads a team of counselors to help Pike County residents understand Medicare and choose the plan right for them. She works for Diakon Community Services for Seniors, under contract by the County, to work closely with the Pike County Area Agency of Aging. She appeared before the County Commissioners, October 18, to discuss the news about this drop in coverage for Pike County beneficiaries, and what they can do.
Not Geisinger’s doing
This was not a voluntary action by Geisinger, Bonnadonna related. Rather, the decision came down from Centers for Medicare and Medicaid Services, a federal agency. A statement Bonnadonna obtained from Geisinger indicated that the reason the plan was being eliminated for 2018 was that there are not enough specialized providers in the network of doctors who serve Pike County people.
Geisinger was actively trying to reinstate Pike County for 2019, she said.
In the meantime, the 700+ beneficiaries in Pike will need to choose another plan.
Technically they have until February 2018, but realistically their Medicare Advantage Plan runs out December 31 so they will need to pick another by January 1st, so there is no lapse, she said.
There are seven other plans, she said, and she is researching them so she can explain the options to her clients. She said she is working to put together informational packets and wants to have informational meetings around Pike County to go over the options.
Residents age 65 and over still have the Basic Medicare plan, but she said this “doesn’t cover very much.”
Aetna is one of the optional companies. Residents can also pick a supplemental plan from a private insurer, to help cover additional costs.
What was so nice about the plan being taken away is that there is no monthly fee and no charge for the premium. She said for a person making, say, $900 a month (on Social Security), this can make a huge difference.
Geisinger has other plans as well, which have charge for the premiums, but these are being taken away from Pike County residents as well, she said.
Screaming & crying
Bonnadonna stated that she was never contacted by Geisinger about the change. Rather, on October 2nd, one of the beneficiaries she has been assisting in Pike County, called her about a letter the woman received from Geisinger announcing the change. Bonnadonna reached out to Geisinger to find out what was going on.
“We kind of went into emergency mode to come up with strategies to try and address the situation,” she said.
When she returned from a vacation, she said she had 75 calls on her voice mail from concerned residents. “I have people calling me screaming, I have people calling me crying,” she said.
At the library in Newfoundland, Bonnadonna went to meet with a client who had an appointment to talk about Medicare. There were eight people waiting to talk to her, she said.
Interestingly, Wayne County did not lose Geinsinger Advantage Plans.
Commissioner Richard Caridi expressed incredulity over why there would be a difference, since Wayne County has the same doctor network. Bonnadonna said she did not understand the logistics of why Geisinger was able to operate in 2017, but not 2018, unless some providers had dropped out of the network.
Senator Baker’s Office was reaching out to Senator Pat Toomey about the issue, she said.
Bonnadonna stated that this happened very suddenly.
A challenge is presented to some seniors, who may find it daunting to find out what they can do. They call a medical provider to ask if they take Aetna, for example, and are told, “I don’t know, call your plan,” she said. “Do you think a homebound woman will call three different providers?,” she said. “I’m doing phone conference calls with people who can’t leave their homes.”
Seniors are also being advised “to go to the website,” she added- a questionable suggestion for a segment of the population less likely to be online.
Bonnadonna has a team of six counselors who are helping address the questions clients have in Pike, and Diakon has an additional counselor that can assist as well.
Pointing to a federal regulation as the instigator for this change, she added that many regulations hurt rural counties like Pike, which has no hospital of its own.
For more information about Medicare, contact the Pike County Area Agency on Aging APPRISE Program at 570-775-5550 ext. 1313.
Also discussed:Pike County residents are reminded to sign up for CodeRED alerts, which send an automatic notification for weather emergencies and other event such as a road closure or gas leak. Alerts are sent to phones, a smartphone app, or by email. Register online at: https://public.coderedweb.com/cne/en-US/BF92C048CF84
State Rep. Mike Peifer is hosting a Concealed /carry firearm seminar on Thursday, Nov. 2, from 6 to 8 p.m. at the Pike County Training Center, 135 Pike County Blvd., Lords Valley (off Route 739). Registration is required to attend: go online at RepPeifer.com or call the district office at 570-226-5959.
Penn State Extension in Pike County is hosting various seminars and webinars. There are also numerous 4-H clubs, including some new ones. Call 570-296-3400 for information.
The Pike County Commissioners meet on the first and third Wednesday at 9 a.m. at the Administration Building, 506 Broad St., Milford.