Neighbor Island seniors on Kaiser grapple with plan changes - Hawaii News Now - KGMB and KHNL

Neighbor Island seniors on Kaiser grapple with plan changes

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BIG ISLAND (HawaiiNewsNow) -

Pahoa residents Jim and Tricia Morlock each pay a $63 monthly premium for their Medicare plans through Kaiser Permanente.

Starting Jan. 1, they'll have to pay a $194 monthly premium if they want to stick with Kaiser.

"That's an extra $260 a month above what we're paying now. We just don't have that kind of income," Tricia Morlock said. "We have other bills to pay and we need to eat."

The couple are among nearly 8,000 Maui and Big Island residents grappling with changes to Kaiser's Medicare plans.

Many plan members are having to decide whether to pay higher premiums, move to another Medicare plan or go to original Medicare.

A Kaiser spokesperson said the changes are needed because federal reimbursement rates for the two islands are significantly lower than anywhere else in the country, making it challenging to cover the rising cost of medical care and prescription drugs.

Kaiser patients on the Big Island and Maui who allow their Medicare Advantage plan to end will still have traditional Medicare parts A and B.

"That will give them all the basic services they need," said state Sen. Josh Green (D-Kona, Kau), who is also an ER doctor. "They would see somebody like me in the ER wherever and that would be perfectly good. They would be able to find a physician, if they can, that takes straight Medicare. That's also been a very big problem."

Medicare expert and radio host Martha Khlopin has advice for those who decide to go back to original Medicare.

"You must pick up a Part D drug plan because many times people take medications every day, but you don't see a doctor or become hospitalized every day," she said.

Khlopin also pointed out that on Maui, Humana is now offering an HMO plan, as well as a Preferred Provider Organization plan, that allows patients who pay a little more to see doctors outside of the network.

"The PPO option is a new option, and I think a lot of people will be interested in that. The premium is showing in Medicare.gov as zero so I think people will be very happy," said Khlopin.

But some patients who require specialized care said leaving Kaiser may not be an option.

"We may have problems on Maui, even if we find a provider that has a price structure that's good, because Maui has limited health care providers and specialty medical facilities," said Kahului resident Mary Spencer.

Financial assistance programs are available. For more information, call Kaiser's Member Services at 1-800-805-2739 (available 8 a.m. to 8 p.m.) or go to www.kp.org/medicare/maui and www.kp.org/medicare/hawaiiisland.

Kaiser will be holding town hall meetings this month to answer questions. Members must RSVP by calling 1-855-226-1023.

For more information on Medicare, click here or call 1-800-MEDICARE.

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