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Innovis drops Medicare health plan

Innovis Health is notifying 1,500 patients that it will no longer honor Medicare Advantage health insurance plans as of April 1.

Innovis determined that the health plans for seniors, an alternative to traditional Medicare with supplemental coverage, is not a good deal for many patients.

"It is the organization's feeling that private fee for service plans are not the best deal for patients," said Kris Olson, vice president of marketing for Innovis.

The plans' low premiums and flexibility were attractive to consumers, but they work best for patients who are very healthy, insurance counselors and health providers agree.

In October, MeritCare announced that it would no longer accept Unicare coverage, a Medicare Advantage plan, effective Jan. 1. That decision affects 3,000 patients, mostly in Minnesota.

Patients with serious illnesses on Medicare Advantage plans can be confronted with very high co-payments, health insurance counselors said.

"If you're really sick, you could end up paying hundreds or thousands of dollars per month," said Cindy Sheldon, director of North Dakota's health insurance counseling program. "They don't meet the needs of everyone."

Those larger-than-expected bills have left many patients owing large sums. Also, the plans often fail to cover some preventive care services or comprehensive management of chronic diseases, including diabetes or hypertension, Innovis informed its Medicare Advantage patients.

Bernie Johnson, director of outreach for Fargo Senior Services, said many patients don't really understand their Medicare Advantage coverage - until they run into problems.

"A lot of times they don't realize the impact until it's too late," she said. "We've definitely seen some problems."

Letters were sent to Innovis patients who are covered by the plans, and the health system has scheduled two meetings to discuss the changes. Patients also received a list of Medicare plans it will continue to accept after April 1.

"We're not trying to endorse any other plans," Olson said. Consumers who want help assessing coverage can call help lines, including North Dakota's State Health Insurance Counseling program or Minnesota's Senior LinkAge.

MeritCare continues to evaluate the Medicare Advantage insurance plans it will accept. Since most of Unicare patients are in Minnesota, it has been referring patients to Senior LinkAge for assistance.

"We've been strongly encouraging our patients that have Unicare coverage to review their options during Medicare's open enrollment period, which goes until Dec., 31," said Doug Okland, MeritCare's executive partner for revenue management services.

Innovis' April 1 deadline should give patients plenty of time to switch coverage, Olson said. The current re-enrollment period runs through the end of March.

After April 1, Medicare Advantage patients who show up for emergency health care still will receive services.

"If someone comes into our emergency room, obviously we will accept them," Olson said. "If someone comes in an ambulance, obviously we will accept them."

If you go

- What: Innovis information meetings for Medicare Advantage patients

- When: 7 p.m. Dec. 1 and 9

- Where: Innovis Health, 3000 32nd Ave. S., Fargo

- Call ahead: To RSVP, call (701) 364-4933.

For more information on Medicare Advantage plans, call:

- North Dakota: State Health Insurance Counseling program, (888) 575-6611

- Minnesota: Senior LinkAge, (800) 333-2433

- Fargo: Fargo Senior Commission, (701) 293-1440.