Insurer: Find new coverage for Part D drug benefit

Mesa County Medicare recipients who have Part D prescription drug benefits through Rocky Mountain Health Plans must seek out new coverage during the open-enrollment period beginning Oct. 15.

The Grand Junction-based health insurer notified customers recently that they would have to consider other carriers for the coverage. The change leaves intact Rocky Mountain Health Plans’ Medicare coverage.

The change stems from the purchase earlier this year of Rocky Mountain Health Plans by UnitedHealthcare.

“This relationship allowed us to evaluate better options for our members, and we concluded that UnitedHealthcare Part D prescription drug plans provided a more robust offering for our Medicare members,” Rocky Mountain Health Plans said. Some of those offerings will cost less than the plans that Rocky Mountain Health Plans has offered, the insurer said.

UnitedHealthcare’s plans offer a variety of coverage options, deductibles, monthly premiums and copays, providing Medicare members access to competitive Part D prescription drug plans, the insurer said.

“We know that our members’ health care coverage is critically important to them, and we are actively working with our Medicare members to ensure they understand their options so they can decide which coverage best meets their needs for 2018,” Rocky Mountain Health Plans said.

Recipients can expect to devote a lot of effort to finding replacement coverage, said Frank Holt, a Grand Junction recipient who said he learned of the change from a mailing over the weekend.

“It means a lot of work, maybe going to and checking out drugs and premiums,” Holt said. “My wife and I are both R.N.s so we know the business and it’s still a lot of work.”

He’s anticipating six to eight hours of work on the computer will be needed to decide which option to pursue. Older recipients might not be inclined to go through the information supplied by Rocky Mountain Health Plans about other options, he said.

Dawn Sudmeier of Cedaredge said she also is anticipating a lot of research to find a plan that will cover the medicine she takes for an autoimmune disease.

So far, she has found one plan that will cover her for $185 a month, but she’s now paying $80 a month.

She could switch to another drug that’s “less effective, has more risks and side effects that are pretty obnoxious,” and after a period of time seek to change to the better option, but there’s no guarantee, Sudmeier said.

“This is real economics and it’s hitting the seniors,” she said.

Notification of the change “came out of nowhere,” Holt said. “We just got this letter on Saturday and that was it.”

The changes affect about 3,600 people in Mesa County and about 7,000 statewide, Rocky Mountain Health Plans said.

Rocky Mountain Health Plans is meeting with members to discuss the options available to them at five meetings in October and November in Grand Junction.

UnitedHealthcare also is conducting a campaign to assist members with questions and help guide them through the process of finding new prescription drug coverage for 2018.

Time is of the essence, Holt and Rocky Mountain Health Plans said.

The annual election period runs from Oct. 15 to Dec. 7.

Recipients who fail to make a selection within that period could go without coverage for the first part of 2018 and could face a lifetime penalty if they don’t act before Feb. 28, Holt noted.

Three meetings for members are scheduled in Grand Junction and two more are scheduled in Fruita.

The Grand Junction meetings begin at 10 a.m. on Tuesday and Oct. 19 and Oct 25 in the Holiday Inn Hotel & Suites, 2751 Crossroads Blvd.

The Fruita meetings also will begin at 10 a.m. and will be Oct. 23 and Nov. 3 at the Fruita Recreation Center, 324 N. Coulson St.

The RMHP Medicare Customer Service team’s phone number is 888-282-1420.


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