Two Delaware healthcare systems and an insurance company plan to form a Medicare Advantage product together to sell in 2022.
ChristianaCare, which dominates health care in Delaware and particularly New Castle County, Bayhealth, which offers services primarily in Kent but also Sussex County, and Highmark Blue Cross Blue Shield Delaware say their product will improve the quality of care and reduce costs for seniors in Delaware.
Medicare Advantage plans are insurance plans that are sold to help administer Medicare services. They usually charge monthly premiums to provide the services they do.
The Delaware organizations’ product still much be approved by the Centers for Medicare & Medicaid Services in order to be offered.
The deal marks the first time the two health care companies have partnered with an insurance company for such a product, which they hope to sell starting Jan. 1.
Most seniors enroll in Medicare at age 65, and as America’s population ages and drugs and procedures become more complex and costly, medical costs rise sharply. Many seniors find it difficult to discern the best Medicare plan to join and, once they are in Medicare struggle with a massive amount of rules and paperwork from each doctor’s appointment or procedure.
Traditional Medicare is made up of four separate programs: Medicare Part A covers hospital stays, follow-up nursing care after a hospital stay, hospice care and some in-home health care. Part B covers things like doctor visits, outpatient hospital services, ambulance services, mental health services, certain therapies, diagnostic services and preventive services. Part C is more commonly referred to as Medicare Advantage, and Part D covers prescriptions.
Medicare Advantage plans can help eliminate some of the confusion of the different Medicare parts by consolidating coverage into one package. but the programs can vary wildly from one offering to another.
Medicare Advantage plans provide the same benefits as traditional Medicare such as hospitalizations, surgeries and drugs, but they also can offer additional benefits like chiropractor visits, dental services and coverage for vision and hearing, as well as result in long-term savings to Medicare members.
Nationally, some Medicare Advantage programs are criticized for offering fewer services than expected, adding costs where they are not expected or forcing patients into their own health care systems rather than following the doctors they always have. Sometimes, belonging to a Medicare Advantage program means a lack of coverage when traveling.
“Participation in a Medicare Advantage plan offers patients excellent care with affordable and predictable out-of-pocket costs, and enhances care coordination, preventive care and care for chronic conditions. ChristianaCare, Bayhealth and Highmark are working together to truly impact the health of Delaware seniors,” said Dr. Christine Donohue-Henry, ChristianaCare’s chief population health officer, in a press release.
“ChristianaCare and Bayhealth are prominent health care providers in the areas of care coordination and outcomes, and they have strong ties to their communities. This collaboration will help increase access to care, enhance the provider-patient experience, and make way for new solutions to improve health for all seniors,” said Alexis Miller, market president, Federal Markets, Highmark Blue Cross Blue Shield Delaware.
Betsy Price is a Wilmington freelance writer who has 40 years of experience.
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