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Medicare insurance plan is discontinued in Stanislaus County. It takes affect Dec. 31.

Modesto Bee - 10/26/2023

Oct. 26—One of the Medicare health plans in Stanislaus County will expire at the end of this year. Thousands of participants are being told they will lose coverage in 2024 if they don't choose another plan.

Officials with the Health Insurance Counseling and Advocacy Program said the Care More plan owned by Anthem will discontinue regular coverage in this county Dec. 31.

Maria Profeta, Health Insurance Counseling & Advocacy Program manager in Modesto, said Anthem Care More will only have a local plan for end-stage renal disease patients.

Profeta said members of Care More began receiving letters from Anthem last week, telling them to take action or they won't have Medicare Advantage coverage next year for hospital costs, medical services and prescription drugs.

The basic Medicare program, for people 65 years and older, covers 80 percent of medical bills. Almost half of Medicare beneficiaries in California sign up for a federally subsidized Medicare Advantage plan to cover hospitalization, physician services, surgery and prescription medications.

Almost 45,000 are enrolled in Medicare Advantage HMO plans in this county, according to the California Department of Health Care Services.

Anthem Care More participants need to make sure the new plan they choose covers their medications, Profeta stressed.

The federal Medicare program has an enrollment period from Oct. 15 through Dec. 7 for making changes to coverage. Profeta said Care More members have until Dec. 31 to make the change but "we don't recommend they wait that long."

Affected residents should keep the notice letter from Anthem. It can serve as a guarantee issue if they want to start the new coverage earlier than Jan. 1, she said. Anthem is legally obligated to give notice 60 days before discontinuing coverage, so affected seniors should receive a letter by Nov. 1.

The Modesto HICAP office, at 3500 Coffee Road, provides unbiased counseling to help people choose a Medicare plan and navigate the national health program. Counselors can help a person determine if a health plan covers their prescription drugs.

HICAP has been holding its annual forums this month to inform seniors about changes to the Medicare program for 2024.

The next forum starts at 1 p.m. Monday (Oct. 30) at the Turlock Senior Center, at 1191 Cahill Ave.

There are 10 Medicare Advantage plans available in Stanislaus County, ranging in cost from a zero monthly premium to $131 per month.

The county has a new plan starting coverage in 2024, called CCA Health California. The CCA plan has no monthly premium and zero co-payments for visits to physicians or specialists.

One change for 2024 is an increase in the Medicare program Part B premium to $174.70 per month, up from $154.90. The Part B premium for physician services is deducted from the Social Security checks of Medicare recipients.

Profeta said another change regards eligibility for Medicare-Medical dual enrollment for low-income seniors, which serves to lower costs for those who qualify. Government agencies, effective Jan. 1, will no longer consider the asset limit of $2,000 to $3,000 for those applying for Medicare and Medi-Cal dual enrollment.

More information about Medicare health plans in Stanislaus County can be found at www.medicare.gov.

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