No Immediate Changes in Health-Care Benefits Expected
Members of FHP International Corp. could see changes in their health-care benefits as early as the end of the year following Friday’s acquisition of the company by PacifiCare Health Systems Inc.
The changes aren’t expected to be big, though senior citizens will see more differences when they switch to PacifiCare’s Medicare plan, which is called Secure Horizons, said Susan Whyte Simon, a PacifiCare spokeswoman.
For the record:
12:00 a.m. Feb. 21, 1997 For the Record
Los Angeles Times Friday February 21, 1997 Orange County Edition Business Part D Page 6 Financial Desk 1 inches; 34 words Type of Material: Correction
FHP and Medicare--A story Saturday on the Medicare benefits offered by FHP International Corp. misstated some of the plan’s terms. Members are not required to make a co-payment for office visits, and the plan has a $3,500 limit on drug benefits.
“It should be business as usual” for most members, she said.
Here are answers to some questions that FHP members and others are asking:
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Q. Can I keep the same doctors, or do I have to switch to PacifiCare physicians?
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A. You’ll keep your same doctors, go to the same clinics and hospitals and retain your benefits probably through the end of this year. You’ll even call the same toll-free number to process claims. PacifiCare received final approval Friday to buy FHP and will operate FHP’s health plans separately for at least most of this year. It still must file for state approval to merge the plans, an action the company plans to take this summer.
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Q. When will I join PacifiCare?
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A. Once the plans are merged, you’ll be switched over to PacifiCare benefits. That isn’t expected to happen until the fall, the typical open-enrollment period for most employers. FHP plans aren’t expected to be offered this fall. New enrollments usually take effect Jan. 1.
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Q. Is that when I’ll have to switch doctors?
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A. Even after the plans merge, most members probably won’t have to switch doctors. PacifiCare expects to use FHP’s doctors as well. About 5,000 physicians serve both companies already, and PacifiCare should end up with a total of 16,000 physicians. Talbert Medical Management Holdings Corp., an FHP-created physicians group, also serves PacifiCare patients.
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Q. How will my benefits change?
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A. The benefit levels at both companies are similar, and the differences in most plans are expected to be minimal even after the changeover.
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Q. Can I switch to PacifiCare now?
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A. No, you can’t switch until the plans are merged. However, if you’re a senior citizen or a disabled person on Medicare and you’re enrolled in the FHP Seniors plan, you can switch to PacifiCare’s Secure Horizons.
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Q. Is there a difference in the senior plans?
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A. Yes. Secure Horizons doesn’t require co-payments for office visits or eye examinations, while FHP seniors pay $3 and $5, respectively. On prescription drugs, Secure Horizons has no monetary limit for generic drugs and a $2,500 limit for brand-name drugs, while FHP has a $1,000 limit for all drugs. But Secure Horizons doesn’t cover chiropractic treatments, while FHP does. The merger of the senior plans must go through a separate approval process and isn’t dependent on the merger of the regular health plans.
