Some worry about changing insurers - and doctors - during treatment
ST. JOSEPH — Waiting to hear details of new Medicare Advantage plans for state retirees has been tough for Nancy Bishop.
She and her husband, Terry, both 69, are state retirees who have been covered by one of the rejected bidders for a new state contract, Health Alliance Medical Plans. And Terry Bishop is in the midst of cancer treatments at Carle and might have to change doctors.
"It is stressful because you're up in the air," the St. Joseph woman said Wednesday. "You can't make plans."
The time for bidders to protest new Medicare Advantage contracts for state retirees ended at midnight Tuesday without any protests being filed, according to the state's chief procurement office.
Details of new Medicare Advantage plans for retirees weren't available Wednesday because the contracts hadn't yet been signed, according to the state Department of Central Management Services.
The Bishops are among about 6,000 Health Alliance retiree-members who see Carle physicians, and the insurer said those Carle members will need to change doctors if they stay with the state's coverage for those on Medicare.
The state will be supplying Medicare Advantage plans through Humana Health plan, Humana Benefit Plan, Aetna Life Insurance Co. and United Healthcare, but Carle doctors do not have Medicare Advantage contracts with those four insurance providers.
"The state worked to procure the best options for its Medicare retirees and their dependents, ensuring cost-effective coverage while giving retirees the quality and continuity of care that they expect and deserve," said Anjali Julka, a spokeswoman for Central Management Services, in an email to The News-Gazette.
"Please note again that members enrolled in the PPO plan can see any provider."
Julka also said new Medicare Advantage plans for state members will be posted on the state CMS website soon.
Earlier this month, Carle officials said the Urbana-based medical group does have a PPO contract with United Healthcare, but it doesn’t include Medicare Advantage patients.
“The only contract Carle has for physician services under Medicare Advantage is with Health Alliance. Carle does have a PPO contract for physician services with United, but it specifically excludes Medicare Advantage,” Carle Chief Financial Officer Dennis Hesch said in a written statement.
Retirees on Medicare can also opt out of the state program and buy coverage on their own, but Nancy Bishop said that could be expensive.
Terry Bishop has non-Hodgkin lymphoma, his wife said, and they fear what an interruption in his care at Carle might mean.
"He's done so well with his doctor that we just don't want to change," Nancy Bishop said.
Her own health is fine, though she's got a heart rhythm disorder Carle is looking after, she said.
"I've been going to Carle since my kids were little, so it's right about 40 years," she said.
Bishop says she's retired from the state Department of Children and Family Services and her husband is retired from the University of Illinois, and she's always believed their health coverage through the state has been great.
Now, she said, she feels the state is trying to force retirees out of the system.
Bishop says her husband needs to undergo a minimum of four more months of chemotherapy treatments "if they can get the lymph nodes shrunk down far enough."
But, she also wonders, if they have to change doctors, "how long will it take us to change somewhere? Will that interrupt his treatment, and will that cause it to flare up again?"