Thousands of Maryland seniors expected to receive notice this month that their supplemental Medicare plans will no longer be available next year, sparking frustration, fear and confusion.<\/p>\n
This article was republished with permission from WTOP\u2019s news partners at Maryland Matters<\/a>.\u00a0Sign up for Maryland Matters\u2019 free email subscription<\/a> today.<\/b><\/p>\n Walkersville resident Marlene Eyler, 74, works as a host at a restaurant and cares for her 20-year-old grandson who lives with her. And now she has to add the chore of finding a new Medicare insurance plan to her challenges.<\/p>\n Eyler, who learned recently that she will lose her Medicare Advantage plan with Aetna, is one of thousands of Maryland seniors expected to receive notice this month that their supplemental Medicare plans will no longer be available next year, sparking frustration, fear and confusion.<\/p>\n \u201cI\u2019m very happy with Aetna, I haven\u2019t had any issues with them,\u201d Eyler said. \u201cI\u2019m just frustrated with the state of Maryland that they can\u2019t give the older people better insurance.\u201d<\/p>\n Insurance carriers say that Maryland\u2019s unique hospital system is costly for them to do business in, and several are reducing their coverage in the state or pulling out of counties entirely. But that leaves residents like Eyler forced to navigate finding a new health care plan for next year.<\/p>\n \u201cI\u2019m taking care of him,\u201d she said of her grandson, \u201cplus having to worry about all this insurance stuff. And I have to work because I can\u2019t pay the bills without working.\u201d<\/p>\n Dean Slaughter, a 70-year-old Annapolis resident, is tired of having to change Medicare Advantage plans year after year. He recently got a letter from Aetna as well, telling him that his plan will no longer be available in 2026.<\/p>\n \u201cNow we get to sit down and do the dog-and-pony show \u2013 see what\u2019s out there, which is not much to offer. The insurance companies are leaving the state of Maryland,\u201d Slaughter said.<\/p>\n Industry experts say as many as 100,000 Medicare recipients in Maryland, like Slaughter and Eyler, will have to scramble to find a new health care plan by the end of the year or risk losing coverage at an age where many require costly medical care.<\/p>\n About a quarter of Maryland Medicare recipients use a supplemental program called Medicare Advantage that helps retirees use a private insurer for additional health coverage such as vision, dental and transportation assistance that the standard Medicare plans may not offer.<\/p>\n But there\u2019s been a long-running problem that\u2019s coming to a head: State officials and people in the health care industry say the Medicare Advantage market in Maryland is more expensive than in most other states because of Maryland\u2019s unique hospital payment system.<\/p>\n In recent years, the state has offered insurers a grant to help cover some of their costs and encourage them to keep offering the coverage in the state. That grant is going away, however, and some insurance companies have shrunk their presence in the state as a result.<\/p>\n A spokesperson for Humana said that the insurance company will no longer offer one of its Medicare Advantage plans in five major Maryland jurisdictions.<\/p>\n \u201cHumana has exited one Medicare Advantage plan in Maryland for next year,\u201d according to the statement. \u201cBeginning Jan. 1, 2026 \u2026 Humana Gold Plus SNP (HMO DSNP), will no longer be available in the following counties: Anne Arundel, Baltimore, Harford, Howard and Baltimore City.\u201d<\/p>\n Humana says that those affected by the termination will maintain their current coverage through Dec. 31, 2025, but they will need to find new coverage during the Medicare Annual Election Period, which runs from Oct. 15 through Dec. 7, if they want coverage next year.<\/p>\n Aetna shrunk its Medicare Advantage coverage to just three counties next year.<\/p>\n \u201cEach year, we assess our ability to meet the health care needs of our members and adjust our plans to ensure they can deliver an excellent and sustainable member experience,\u201d a spokesperson for Aetna said in a written statement. \u201cIn 2026, in Maryland, we will offer Medicare Advantage in the following counties: Frederick, Harford and Montgomery.\u201d<\/p>\n Part of the issue comes from Maryland\u2019s unique Total Cost of Care hospital payment model, in which a state board called the Health Services Cost Review Commission (HSCRC) sets hospital rates. Under the current system, insurance carriers pay higher hospital rates than in other states and get reimbursed by the federal government for Medicare Advantage services at lower rates than elsewhere. Meanwhile, insurance carriers are unable to negotiate hospital rates under their plans.<\/p>\n As a result, it\u2019s more expensive to use Medicare Advantage in Maryland than in other states, and Maryland seniors aren\u2019t getting the same quality of benefits, a spokesperson for CareFirst said in a recent statement.<\/p>\n Insurers reducing their footprint in the state leaves residents like Jie Shen, a 68-year-old living in Cockeysville, having to look for a new plan. That often means finding new doctors and hospitals for health care services.<\/p>\n \u201cThis is getting very frustrating,\u201d Shen said. \u201cI just want to stay on one plan at this point. I don\u2019t know which one to choose.\u201d<\/p>\n While there is time to search for a new plan, Medicare Advantage recipients note that the options available in Maryland are dwindling as carriers pull out of the state.<\/p>\n \u201cIt\u2019s a hassle,\u201d Slaughter said. \u201cAll of a sudden, you\u2019re working with people who don\u2019t even know you, and it\u2019s not the way I want it \u2026 I feel like I am a number, and a cattle in line instead of a person, and it\u2019s degrading.\u201d<\/p>\n Even those who will still have their plans in 2026 are worried about what may come down the pipeline later.<\/p>\n Sharon Vickers, 78-year-old resident of Pasadena, was relieved to hear that her Medicare Advantage plan with CareFirst will continue into next year.<\/p>\n \u201cI was concerned. Especially since my husband has passed, not having someone to sit and talk about it and discuss it,\u201d she said.<\/p>\n As many Medicare recipients do, she works with an insurance broker to help find appropriate coverage for her needs. The broker informed her that she would be \u201ccomfortable this year,\u201d but that he couldn\u2019t \u201cguarantee anything for next year.\u201d<\/p>\n But she feels that the Advantage plans are already too expensive for what they offer and may skip out on coverage entirely.<\/p>\n \u201cI may be looking at one day not being able to afford health care coverage,\u201d Vickers said. \u201cI\u2019ll do what I have to do when the time comes, and that may mean going without health care.\u201d<\/p>\n Meanwhile, the Maryland model is undergoing a major transition this year, as state health officials and federal officials finalize new terms of the States Advancing All-Payer Health Equity Approaches and Development, or AHEAD, model.<\/p>\n Current negotiations appear to prompt the state to offer solutions to the stabilize Medicare Advantage. There may also be significant changes to the state\u2019s Medicare rate-setting authority.<\/p>\n Shen, like other Medicare recipients, hopes something can be done so that insurers will stay in the state.<\/p>\n \u201cI don\u2019t know if the state can help, but that\u2019s what I ask for,\u201d he said. \u201cThey should do something.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"Thousands of Maryland seniors expected to receive notice this month that their supplemental Medicare plans will no longer…\n","protected":false},"author":3,"featured_media":303396,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[35],"tags":[210,1141,1142,154030,3235,28533,67,132,68],"class_list":{"0":"post-303395","1":"post","2":"type-post","3":"status-publish","4":"format-standard","5":"has-post-thumbnail","7":"category-health-care","8":"tag-health","9":"tag-health-care","10":"tag-healthcare","11":"tag-maryland-health-insurance","12":"tag-medicare","13":"tag-medicare-advantage","14":"tag-united-states","15":"tag-unitedstates","16":"tag-us"},"share_on_mastodon":{"url":"https:\/\/pubeurope.com\/@us\/115374147821325372","error":""},"_links":{"self":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/303395","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/comments?post=303395"}],"version-history":[{"count":0,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/posts\/303395\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media\/303396"}],"wp:attachment":[{"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/media?parent=303395"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/categories?post=303395"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.europesays.com\/us\/wp-json\/wp\/v2\/tags?post=303395"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}