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Alignment Healthcare Adds MemorialCare Hospitals and Doctors to 2021 Medicare Advantage Provider Network

Nationally ranked nonprofit health system and Medicare Advantage insurance provider sign agreement to expand access to care for Medicare-eligible beneficiaries in Southern California

MemorialCare, a leading nonprofit health system in Southern California with hundreds of primary care and specialty providers, four top hospitals and 200 locations, is joining Alignment Healthcare’s Medicare Advantage provider network starting Jan. 1, 2021, expanding its scope of coverage to 2 million Medicare-eligible residents in Los Angeles and Orange counties.1

This means that Medicare beneficiaries who enroll in select plans from Alignment – named one of four 2020 Best Insurance Companies for Medicare Advantage in California by U.S. News & World Report – will have access to MemorialCare’s hospitals, health centers and urgent care locations and may seek “in-network” care from physicians associated with MemorialCare Medical Foundation. Medicare’s annual enrollment period for the 2021 plan year begins Oct. 15.

“As part of Alignment’s network, we will ensure that more people will have increased access to MemorialCare’s renowned services,” said Mark Schafer, M.D., CEO, MemorialCare Medical Foundation, which includes MemorialCare Medical Group, Greater Newport Physicians, and Edinger Medical Group. “MemorialCare has a long, 113-year history of providing quality care to Southern California communities, and joining Alignment’s network allows us to continue delivering on that commitment.”

Alignment Healthcare continues to grow and recently announced in August that it plans to expand its Medicare Advantage plans into several new markets across California, Nevada, and North Carolina starting in 2021. Alignment’s health care delivery model – powered by its proprietary command center technology AVA™ – and ACCESS On-Demand Concierge program, launched in 2019, offers its Medicare Advantage members white-glove service such as round-the-clock access to a doctor by phone or video, a dedicated concierge team, and a black benefits card that can be used like a debit card – all at no additional cost. Depending on their plan, members receive a monthly allowance automatically loaded onto their black card to purchase eligible over-the-counter and grocery benefit items at more than 50,000 retailers nationwide.

“At Alignment Healthcare, we are always looking for ways to make our members happy, and we hope they will be pleased with having access to MemorialCare’s top-rated doctors, hospitals and services,” said Dawn Maroney, president of consumer and markets, Alignment Healthcare. “This announcement is also an important consideration for Southern Californians who are making a decision about their 2021 Medicare coverage during this year’s Medicare Annual Election Period – to know what health care providers will be available to them in their health plan’s network when they need it in 2021.”

MemorialCare’s Long Beach Medical Center, Orange Coast Medical Center, Saddleback Medical Center and Miller Children’s & Women’s Hospital Long Beach have been recognized by U.S. News & World Report as one of America’s Best Hospitals and “high performing” in numerous clinical categories since the rankings began. In addition, MemorialCare Medical Foundation comprises more than 350 primary care physicians and 2,250 specialists in the areas of internal medicine, family medicine, pediatrics, geriatric medicine, pulmonology,

The Best Time to Switch From a Medicare Advantage Plan to a Medigap Plan

Last of a three-part series.

Medicare’s annual election period runs from Oct. 15 through December 7.

And that’s the best time to switch from a Medicare Advantage plan to a Medigap plan, according to Jae Oh, author of Maximize Your Medicare.

According to Oh, it’s critical that your Medigap carrier your application before you switch out of your Medicare Advantage and sign up for a standalone Part D plan. The worst outcome, he says, would be to have your Medigap application denied and choose a Part D plan. That would “eject” the Medicare Advantage plan that you may have in place and leave you without additional health benefits, said Oh.

Watch Oh’s videos on the topics on YouTube. Also read Buying your Medigap policy.

So, why might you switch from a Medicare Advantage plan to a Medigap plan?

There are a few reasons, according to Oh. The annual contracts are subject to change every year. And those changes could include premiums, copays, deductibles and doctors. By contrast, under Medigap, there is no concept of network. Every health care provider accepts a Medigap plan. To be sure, the premiums might cost more. But buying a Medigap plan could be one way to manage and mitigate the risk of unexpected health care costs in retirement,

So, what’s the best way to search for and select a Medigap policy?

1. Start with Medicare’s Plan Finder tool. One drawback with the tool, according to Oh, is this: The transparency of Medigap premiums is not very good. “The prices don’t accurately reflect the most updated premiums from carrier to carrier,” he says.

And as a result, it can be too high in certain instances. And that can be a disincentive; people might look at the list and think it’s too expensive when in fact the actual price in the marketplace is much lower. “It’s just been my general observation that the prices are not exactly at the razor’s edge of where the market sits at that time,” said Oh.

One bit of good news, according to Medicare.gov, is this: Every Medigap policy must follow federal and state laws designed to protect you, and it must be clearly identified as “Medicare Supplement Insurance.” Insurance companies can sell you only a “standardized” policy identified in most states by letters. All policies offer the same basic benefits but some offer additional benefits, so you can choose which one meets your needs. In Massachusetts, Minnesota, and Wisconsin, Medigap policies are standardized in a different way.

When selecting a plan, Oh said the two most important factors to consider are the type of plan that best suits your needs and the carrier. And it’s really important to get the carrier right. You shouldn’t choose just any carrier, he says. Since underwriting is involved, there are certain instances where oh might suggest one carrier that is more likely to accept an applicant versus another.

2. Your local State Health Insurance Assistance Program (SHIP) will provide you in-depth, one-on-one insurance counseling and

Health Insurers Lay Groundwork For Biden And ‘Medicare Advantage At 60’

Health insurance companies are expanding Medicare Advantage health plan offerings to seniors in hundreds of new counties for 2021 as new regulations allow for new benefits and the program becomes more popular.

But these health plans could also be establishing a beachhead for perhaps an even bigger draw of seniors if a Joe Biden White House successfully convinces Congress to lower the eligibility of Medicare to 60.

As the presidential campaign heats up in its final month, Biden is stepping up talk about his healthcare proposal that includes allowing Americans between the ages of 60 and 64 the option of buying into Medicare, the federal health insurance program for the elderly. The proposal is considered less costly than earlier versions proposed by Democrats in the U.S. Senate to lower Medicare eligibility to as young as 55 or even 50 and is expected to allow private insurers to offer Medicare Advantage at a younger age just as they do now for existing eligible Medicare beneficiaries.

Meanwhile, the Trump administration supports Medicare Advantage but doesn’t have a plan to lower the age of eligibility. Health insurers aren’t weighing in on a general election presidential endorsement, but advocates and lobbies to expand Medicare Advantage see potential to expand if eligibility widens to more Americans.

“With Medicare Advantage’s steady growth in enrollment and the increasing evidence of its value through better costs and better outcomes for beneficiaries, it would be our expectation that any proposal to extend Medicare to more beneficiaries would include a strong role for Medicare Advantage,” says Allyson Y. Schwartz, who is president and CEO of the Better Medicare Alliance, which includes an array of business, community, health groups and insurers like Humana, CVS Health, parent of Aetna, and UnitedHealth Group.

Insurers began last week announcing their expansions in new regions ahead of the annual open enrollment period when seniors eligible for Medicare can choose new benefits or stay with their existing plans. Such changes can be made during Medicare’s open enrollment, which runs Oct. 15 through Dec. 7.

Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines with some also offering vision, dental care and wellness programs.

Every state in the U.S. offers Medicare Advantage and choices of plans are soaring with practically every major plan offering options that include “$0 Medicare Advantage 2021 premiums.” 

Among those that have already announced their Medicare Advantage expansions include Cigna, Humana, UnitedHealth Group and newer companies like Alignment Healthcare, which said last week it is offering 36 Medicare Advantage options