Many seniors in Stanislaus County face losing their insurance Aug. 1 because of the financial problems of the Medicare health system.
The Golden State Medicare Health Plan sent letters in late June informing members that its contract with Medicare was effectively terminated in Aug. 1. Golden State enrollees will lose their insurance Aug. 1. Adults with other insurance plans are not affected.
The State Department of Managed Health Care took action last year to revoke the health plan’s license in the Golden State based on the insurer’s financial woes.
According to a formal agreement with the state agency, which oversees managed care in California, the Golden State reported a revenue of $27 million in the April 2021 financial year and a deficit of $35 million in December. The Department of Health’s April 2021 order prohibited the Golden State from accepting new enrollment applications.
The Golden State provides insurance to Medicare recipients in Stanislaus, San Luis Obispo, San Francisco counties and five Southern California counties.
“We’re getting a lot of calls from these people,” said Maria Profeta, manager of the Health Insurance Counseling and Advocacy Program in Stanislaus County.
Profeta said the HICAP office, which helps people manage the Medicare system, is making 10 or more visits a week to help them sign up for another insurance. Ten other insurance carriers offer Medicare Advantage health plans in Stanislaus County.
A Golden State representative in Newport Beach could not be reached Wednesday. A tape recorder said the health plan would end on August 1 and advised members to call the Medicare program or go to Medicare.gov website to find other insurance.
The Modesto HICAP office did not have a Golden State membership count in Stanislaus County.
Profeta said Golden State customers who don’t change could lose health care coverage and will revert in August to Medicare benefits, which don’t cover the full cost of hospitalization, Profeta said.
“It can be difficult to see a doctor, because many doctors do not work with Medicare,” he added.
In addition to the Modesto HICAP office, the program provides impartial assistance to Medicare beneficiaries with satellite locations in Turlock, Ceres, Oakdale and Patterson. People living in remote areas can call HICAP to make an appointment for assistance in satellite areas. HICAP also offers counseling sessions by phone or video.
The HICAP program will hold an enrollment ceremony on Aug. 18 from 8 a.m. to 11 a.m. at the Stanislaus County Library, 1500 I St., Modesto. The Modesto Farmers Market will also be held at that time. Representatives from various insurance plans will answer questions about their approved Medicare plans.
Golden State began serving members in Stanislaus County in 2015. It provided services at zero premiums and no copayments for inpatients and doctor visits.
The Health Insurance Counseling and Advocacy Program in Stanislaus County can be reached at 209-558-4540. The Medicare toll-free number is 800-633-4227 or go to Medicare.gov.
This article was originally published July 21, 2022 6:00 AM.