The Mississippi Insurance Department learned this week that Southwest Health System located in Pike County, Mississippi will drop its Wellcare Medicare Advantage agreement at the end of the year.
Once the Medicare Advantage network agreement ends, some visits would be considered out-of-network and policyholders would receive reduced benefits.
Insurance Commissioner Mike Chaney said, “We do not regulate Medicare Advantage plans. That’s the federal government. We do, however, get involved to protect the consumer because it’s such a hot button issue. From what we understand, Wellcare has over 30,000 Advantage consumers in the state. They tell us that they only have 800 in Pike County and that they are working to secure several facilities that will see Wellcare patients within 10 miles of the hospital.”
Patients may go to other in-network hospitals in the area including: Kings Daughter Medical Center, Walthall County General Hospital, and Marion General Hospital.
A similar situation is playing out in Tupelo. North Mississippi Health System is ending a multi-year Medicare network agreement with Humana on December 31, 2018. Humana has reported that negotiations with the hospital, started in June 2018, have been unsuccessful.
Commissioner Chaney says this is an example of reimbursement issues.
“We’ve had 5 hospitals close since 2013 and four have filed bankruptcy in the past three weeks. There will be more if we don’t get a handle on the problem,” Chaney said.
Alternative in-network hospitals in North Mississippi include Baptist Memorial Hospital with several facilities, OCH Regional Medical Center in Starkville and Trace Regional Hospital in Houston, MS.
Patients should consider other healthcare plans but they need to do so quickly. Medicare Open Enrollment started October 15th and continues through December 7, 2018. Once enrolled in Medicare, consumers can choose supplements or Medigap for expenses not covered by Medicare.
Consumers can visit www.mid.ms.gov to look at Medicare plans and shopper’s guides.
Those with questions for Wellcare should call the Customer Service number on the back of their insurance card.
Humana Medicare providers in North Mississippi with questions or concerns should call the Humana customer service toll free number (800) 457-4708.
Humana Medicare members in North Mississippi with questions or concerns should call the toll-free phone number on the back of their Humana ID cards.
Insurance Commissioner Mike Chaney Press Release