forced to chang<\/a>e their insurance due to policy cancellations and drastic changes in 2027. National health insurers such as UnitedHealthcare, Humana and Centene are scaling back Medicare Advantage plans and pulling out of certain markets to preserve their profits.<\/p>\nHMSA, an independent licensee of Blue Cross Blue Shield, said it does not plan to end its Medicare Advantage offerings as some other Blue Cross plans have done, but had to revamp them to remain sustainable.<\/p>\n
\u201cWe needed to make a change in these plans because our commitment is that HMSA is going to stay,\u201d said HMSA CEO Dr. Mark Mugiishi in an earlier interview. \u201cWe are going to stay in the state, we\u2019re going to stay in Medicare Advantage, we\u2019re going to stay on all islands.\u201d<\/p>\n
HMSA said a follow-up packet of information, including enrollment forms, has been sent to impacted members with easier-to-\u00adunderstand details on the new plans and rates. The earlier notice, HMSA said, was written as required by the U.S. Centers for Medicare & Medicaid Services, which oversees Medicare.<\/p>\n
HMSA representatives are also calling every Akamai Advantage member impacted by the changes.<\/p>\n
\u201cWe understand that Medicare Advantage members may have questions about HMSA\u2019s Akamai Advantage Select Plus HMO network and how Queen\u2019s decision relates to this new plan option,\u201d said Kimberly Takata Endo, HMSA vice president of Medicare, in a statement. \u201cQueen\u2019s continues to be a participating HMSA provider and are in network for HMSA\u2019s Medicare Advantage PPO and Dual Care plans. This means that members in the broader HMSA Medicare Advantage PPO population can continue seeing Queen\u2019s providers as they do today.\u201d<\/p>\n
While Queen\u2019s is not included in the Select Plus HMO network, she said, emergency and urgent care remain covered for all HMSA Medicare Advantage members, including Select Plus enrollees.<\/p>\n
The Select Plus HMO network includes more than 60% of the providers in HMSA\u2019s Medicare PPO network.<\/p>\n
While it is not expected to be the highest membership plan in the portfolio, Endo said: \u201cOur intent was to offer more choice, and diversify the plan options available.\u201d<\/p>\n
The HMO Select Plus directory of providers includes their affiliations with various hospitals, which includes Queen\u2019s, even though it is not included in the Select Plus network. HMSA clarified these are affiliations, and many providers are affiliated with multiple hospitals, including Queen\u2019s.<\/p>\n
Queen\u2019s, meanwhile, sent memos Oct. 1 to its providers and staff, along with letters to its patients, informing them it will not be a participating provider in the new Select Plus HMO plan.<\/p>\n
In its letter to patients, Queen\u2019s said: \u201cIf you enroll in the new HMSA Select Plus HMO plan, Queen\u2019s hospitals and clinics will be out of network, and services provided at Queen\u2019s would be subject to your plan\u2019s out-of-network benefits and requirements.\u201d<\/p>\n
If an HMSA Select Plus patient visits Queen\u2019s, the hospital will follow its out-of-network procedure at the time of registration.<\/p>\n
Queen\u2019s said it would place posters at patient access points, send information to health insurance brokers and set up a call center to answer questions.<\/p>\n
Patient reaction <\/p>\n
Marla Malinski, a lung cancer survivor in Hilo, is stressed about losing her Standard Plus PPO plan and having to reenroll. She said she got the initial disenrollment notice, followed by a letter from HMSA \u201cbasically saying that prices went way up.\u201d<\/p>\n
Malinski, 72, would not be able to enroll in the HMO plan, as it is only available to members on Oahu, and has questions about what Medicare supplemental coverage will cover.<\/p>\n
She also got a letter from Queen\u2019s informing her of its decision not participate in it. Malinski had surgery at Queen\u2019s two years ago to remove the lower lobe of one of her lungs and still goes in every six months for follow-up appointments.<\/p>\n
\u201cMy surgeon is there, and she\u2019s the best,\u201d she said.<\/p>\n
Dr. Katie Min, an independent doctor whose office is at Queen\u2019s Physicians Office Building 1 in Honolulu, said she accepts original Medicare, along with many Medicare Advantage plans by Humana, Devoted and UnitedHealthcare, and would accept those opting for HMSA\u2019s new HMO plan.<\/p>\n
Her main concern is the ability to make referrals to Queen\u2019s specialists for patients who might not be covered under the new plan.<\/p>\n
\u201cA lot of my patients like Queen\u2019s,\u201d she said, \u201cso I have a feeling a lot of my patients won\u2019t do that plan.\u201d<\/p>\n
Kathy Ginoza-Arakaki of Honolulu said she wishes HMSA would have been more up-front informing members of the major changes. She helps her 99-year-old aunt and panicked when she saw the letter saying the plan was ending.<\/p>\n
\u201cI\u2019m really upset with them,\u201d she said. \u201cI used to work with a lot of elderly and I feel bad they\u2019re going to get this cancel (notice) and not know what to do.\u201d<\/p>\n
Details on new plans should have been sent the same day or next day, she said, so people were reassured of not being dropped altogether. She called for more transparency on details, including that Queen\u2019s will not be part of the HMO plan.<\/p>\n
Although Queen\u2019s said it was opting out of the plan until there is more clarity, it said in a FAQs section of its memo it has no plans to participate in HMSA Select Plus HMO at a later time.<\/p>\n
Queen\u2019s also said the decision was not related to HMSA contract negotiations, referring to the insurer\u2019s plans to vertically integrate with Hawai\u2018i Pacific Health. Queen\u2019s CEO Jason Chang has been a vocal opponent of the merger, saying it would reduce competition, raise costs and narrow access to care.<\/p>\n
Additionally, Queen\u2019s emphasized it does not sell or recommend insurance plans and encouraged patients to carefully review their plans to make a fully informed decision.<\/p>\n
\u2014<\/p>\n
Questions about Medicare?<\/p>\n
>> The Queen\u2019s Health System call center at 808-691-2243 is available 8 a.m. to 4 p.m. Monday to Friday to answer questions about its participation in HMSA plans.<\/p>\n
>> Call HMSA at 800-693-4672, visit hmsa.com\/medicare<\/a> or go to an HMSA Center for assistance.<\/p>\n>> The Hawaii State Health Insurance Assistance Program (SHIP) can be reached at 808-586-7299 or toll-free 888-875-9229.<\/p>\n
>> Call the Centers for Medicare & Medicaid Services at 800-MEDICARE.<\/p>\n
\u2014<\/p>\n
HMSA Medicare Advantage options for 2027<\/p>\n
Akamai Advantage<\/p>\n
>> Complete Plus, available on Oahu, $240 per month (previously $160 per month)<\/p>\n
>> Complete (PPO), available on Oahu, $55 per month (previously $20 per month)<\/p>\n
>> Select Plus (HMO), available on Oahu, $45 per month<\/p>\n
>> Standard Plus (PPO), available on neighbor isles, $240 per month (previously $151 per month)<\/p>\n
>> Standard (PPO), available on neighbor isles, $50 per month (previously $20 per month)<\/p>\n
Source: HMSA<\/p>\n","protected":false},"excerpt":{"rendered":"Hawaii\u2019s largest insurer is rolling out a new, lower-cost plan for its Medicare Advantage patients, but The Queen\u2019s…\n","protected":false},"author":2,"featured_media":879419,"comment_status":"","ping_status":"","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[59],"tags":[6813,97,252,253],"class_list":["post-879418","post","type-post","status-publish","format-standard","has-post-thumbnail","category-health-care","tag-editors","tag-health","tag-health-care","tag-healthcare"],"_links":{"self":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/879418","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/comments?post=879418"}],"version-history":[{"count":0,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/posts\/879418\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media\/879419"}],"wp:attachment":[{"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/media?parent=879418"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/categories?post=879418"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.newsbeep.com\/us\/wp-json\/wp\/v2\/tags?post=879418"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}