Archived Article: FAQ Managed Care - HealthNet News Flash 2002

MEDICARE HMO FLASH:
Health Net (PHS) 2002 Medicare Plan Will Increase Costs to Members and Limit the Number of Participating Hospitals

Health Net, formerly known as Physician Health Services, or PHS, has announced that it will continue to offer a managed care plan for Medicare beneficiaries in 2002. The plan will be available in Fairfield, Hartford, and New Haven counties. However, Health Net has also announced that the plan will be more expensive to beneficiaries in 2002 and will not include the same level of covered services. Furthermore, the number of new members able to enroll in the plan will be limited.

Please note the following important changes regarding the Medicare Health Net plan for 2002:

1. Two hospitals previously in the Health Net/ PHS network will NOT be participating in 2002. These are Hartford Hospital and Danbury Hospital. (Greenwich Hospital has now contracted with Health Net.) Thus, unless the individual needs emergency or urgent care, services provided at any of these hospitals will not be covered in 2002.

Further, physicians who have admitting practices only at these hospitals will not be able to participate in Health Net in 2002. Thus Health Net members who use these doctors, as a primary care physician or specialist, may have to seek new doctors.

2. Premiums for 2002 will increase by $20 per month, from $79/month to $99/month.

3. Co-payments will be added for outpatient and inpatient surgery, radiology, diabetic, and dialysis benefits.

4. The co-payment for prescription drugs will increase $3 per prescription, from $7/prescription to $10/prescription. Coverage is for generic drugs only.

Note: Individuals considering enrolling in the Health Net Medicare managed care plan for 2002 should take these changes into consideration and think carefully before deciding to join the plan.

• Individuals formerly enrolled in Health Net/ PHS will automatically be enrolled in Health Net

• If, after reviewing the changes in Health Net, the individual member decides another choice is preferable for 2002, he or she must take action to dis-enroll.

For further information and assistance contact the Connecticut CHOICES program. A CHOICES staff member can help you think through your options and make an informed decision. (800)994-9422.