Kaiser to Discontinue “Basic” and “Enhanced” Senior Plans on Maui

Kaiser Senior Advantage Information session details.

Kaiser has announced it will discontinue its “Basic” and “Enhanced” individual Medicare plans for seniors on Maui after Dec. 31, 2016.

Effective in the new year, on Jan. 1, 2017, there will be one plan available to Medicare-eligible Maui residents, called the Kaiser Permanente Senior Advantage Maui (HMO).

Kaiser representatives say there are an estimated 4,000 individual Senior Advantage members on Maui, with the cost difference for those impacted to range from $14 to $156.

The Basic 2016 premium was $38 and currently has 1,772 enrolled individuals.  The Enhanced 2016 premium was $180 and currently has an enrollment of 2,238 individuals.  The new Kaiser Permanente Senior Advantage Maui (HMO) premium is $194.

Kaiser representatives say this new plan is competitively priced with others in the marketplace.

“Closing the Maui and Big Island plans was a difficult decision and we did this only after reviewing all the options available to us at this time,” said Laura Lott, Kaiser Permanente Hawaii’s Communications Director.  “The changes we are making this year will allow us to deliver high quality health care for all our members over the long term.”

Lott noted that the federal government reimburses Kaiser Permanente for each service area at a different rate, with rates varying by island. “Hawaiʻi Island and Maui have significantly lower reimbursement rates than anywhere else in the country making it challenging to cover the rising cost of medical care and prescription drugs,” Lott told Maui Now.

Kaiser representatives said all health plans face the same health care financial pressures with some plans raising premiums and reducing benefits, while others previously decided to leave the Medicare market entirely.

“We are committed to continuing to serve Medicare members,” said Lott.  “Our Medicare premiums and copays are determined by our cost of providing medical care, prescription drugs, and other services; how much Medicare reimburses plans; and benefits that Medicare requires that we offer our members,” she said.

Kaiser will host several information sessions for Maui residents with the schedule to include the following dates and times:

• Lahaina Civic Center Complex: Oct. 17, 2016, at: 10 a.m., 1 p.m., and 3 p.m.
• Maui Arts & Cultural Center: Oct. 18, 2016 at: 10 a.m., 12 noon, 2 p.m., and 4 p.m.
• Maui Arts & Cultural Center: Oct. 21, 2016 at: 9 a.m., 11 a.m. and 2 p.m.
• Eddie Tam Memorial Complex: Oct. 19, 2016 at: 9 a.m. and 11 a.m.
• Wailuku Community Center: Oct. 20, 2016 at: 10 a.m., 1 p.m., 3 p.m. and 5 p.m.

*Seating is Limited.  Please call 1-855-226-1023 between 8 a.m. and 8 p.m. to RSVP.  

Kaiser representatives say financial assistance programs are also available.  Information and applications are available online or by calling (800) 805-2739.

New plan details: Hawaiʻi Island

On Hawaiʻi Island, there are approximately 3,900 individual Senior Advantage members.  Kaiser will be discontinuing the “Essential” and “Essential Plus” individual Medicare plans on Hawaiʻi Island after Dec. 31, 2016.

Effective Jan. 1, 2017, there will be one plan available to Medicare-eligible Hawaiʻi Island residents. It will be called Kaiser Permanente Senior Advantage Hawaii Island (HMO).

The Kaiser Permanente Senior Advantage Hawaiʻi Island (HMO) premium of $194. (The Essential 2016 premium was $63 and has a current enrollment of 2,305 individuals; and the Essential Plus premium was $202 and has a current enrollment of 1,640 individuals). Kaiser representatives say this new plan is competitively priced with others in the marketplace.

New plan details: Oʻahu

There are approximately 8,600 individual Senior Advantage members on Oʻahu.  Oʻahu residents do NOT need to re-enroll.

Changes to Medicare plans on Oʻahu are effective Jan. 1, 2017 and include the following:
The Basic plan premium in 2017 will be $59. (2016 premium was $38)
The Enhanced plan premium in 2017 will be $179. (2016 premium was $180)

“We know that these changes may be difficult for some seniors so there are financial assistance programs available (details available by calling number or visiting web site listed above). Given the rising cost of medical care and drugs and current Medicare reimbursement rates these changes are necessary. We want to be here to care for all our members for many years to come. To do that, we have to be financially stable,” said Lott.