By Karen Courtney, Director of Programs, CareWell Services
Bronson Health and Oaklawn have both terminated contracts with Meridian Health Plans for 2024. Persons using Meridian plans for either Medicaid or Medicare will want to look at their options for change during the upcoming Annual Open Enrollment periods. Plans affected include: Meridian Health Plan Wellcare Advantage, Meridian Health Plan Medicaid, Meridian Health Plan MiHealth Link for Dual Eligibles, and Ambetter Meridian Health Exchange.
Letters have gone out to many insured persons, notifying them of the change. Meridian beneficiaries may have to make insurance changes before the end of the year in order to keep seeing their preferred doctors.
Persons who have both Medicare and Medicaid, who wish to use a “Duals” plan, would need to select United Healthcare Duals plan to have a plan which is accepted at BOTH Bronson Battle Creek AND Oaklawn. Oaklawn will also remain in-network with Aetna Better Health duals plan for 2024.
A release issued by Oaklawn last month stated:
“As a result of Meridian’s continued refusal or inability to resolve open issues, Oaklawn has no choice but to issue a letter of contract termination to Meridian. In following the terms of their contract with Meridian, Oaklawn is providing Meridian with formal notice of its intent to terminate their contract, effective Dec. 31, 2023.
The termination of this agreement means that, as of Jan. 1, 2024, Oaklawn (and all of its affiliated physicians and health care providers) will no longer be considered “in-network” for Meridian’s health plan.”
Bronson also issued a release that stated, “After extensive discussions between Bronson and Meridian, we unfortunately were unable to reach an agreement that would allow us to continue providing services under their network. We apologize for any inconvenience this may cause you. The good news is, we participate with several other alternate Medicaid and Medicare plans that offer great coverage and we encourage you to enroll with one of those to continue your care with Bronson providers.”
Oaklawn and Bronson listed alternative plan options in their statement.
As Annual Enrollment approaches, we will be seeing more advertisements for Medicare health and drug plans. Independent for-profit, lead-generation, and sales broker companies are behind many of the ads. It’s a big-money industry. Brokerages, agents and other marketing businesses try to convince Medicare recipients to switch plans, with promises of perks in their new plans such as home-delivered meals, rides to doctors’ appointments and cash. Commission agents at the advertised numbers often never even check whether clients’ doctors participated, or if clients’ medications were on formulary with the proposed plan.
Despite Medicare rules crackdowns, lazy opportunistic sleazy sellers will still be out there, trying to take advantage to make a quick commission buck. Be vigilant and skeptical! Do not give your Medicare number out over the phone, unless you have dialed 1-800-Medicare to speak to a Medicare customer service representative. If you didn’t instigate the phone call, don’t give out your insurance or personal information, period.
Remember—if it sounds too good to be true, it might not be true. The “money back in your check” claim is typically only for low-income, low-asset beneficiaries, who qualify for state Medicaid assistance paying their Part B premium. MMAP can screen you to see if you’re eligible to apply.
MMAP, the Medicare Medicaid Assistance Program, is the State Health Insurance Information Program (SHIP) for Medicare in the state of Michigan. MMAP benefits counselors are trained to compare public Medicare plans, including the Medicare-Medicaid duals plans. They will assist clients in making certain all their medications are accepted by the plan, and they will help verify whether the clients preferred doctors, specialists, hospital(s), and pharmacy all participate with the plan chosen.
Call MMAP at 1-800-803-7174 for free, unbiased assistance in comparing plans. MMAP counselors work by appointment only—no walk ups. When calling for an appointment, please know your annual income and approximate assets totals—this will help counselors phone screen you for potential cost savings programs like the Medicare Savings Program for premiums help or the Extra Help for prescription cost reductions program. If it sounds like your income and assets are close to the qualifying ranges, and you need help applying for those programs, as well as an annual plan review, the counselor will set a longer appointment time to accommodate all your needed services. They’ll also let you know the ID, insurance cards, prescription medications list, income, and asset documentation you will need to bring in order to apply or do a plan review and potential enrollment.
Counselors are also aware of local resources, like Millage’s hearing, vision, dental, and fall alert button, which don’t require you to make ANY changes to your insurance!
You can call the statewide MMAP hotline at 1-800-803-7174 to be directed to the nearest site manager’s office. You should use counselors in your home county; every county has an Area Agency on Aging which can direct you to local counselors.
CareWell Services Southwest provides counseling at Kool Family Community Center in Battle Creek and Heritage Commons Senior Enrichment Center in Marshall; call the 800-803-7174 number to schedule appointments at those sites.
CareWell Services Southwest also has trained MMAP counselors at Forks Senior Center in Albion at (517) 629-3942, Albion Health Care Alliance at (517) 629-5080, and Calhoun County office of Senior Services at (269) 781-0846. Barry Commission on Aging handles MMAP services for Barry County. Call the statewide hotline number to geo-route your call if in Barry County, or dial direct to (269) 948-4856.
If your doctors still take your current plan and your meds are still on formulary you don’t HAVE to make any changes during open enrollment. Ignore the TV ads, and call MMAP to make sure you are still getting the most bang for your health care buck.
