Seniors’ Health Insurance Comes at Big Premium

Lourdes and Fidel Ramirez knew their medical costs were going up. They just didn’t know by how much.

The Oxnard couple recently got the painful answer: a lot.

Lourdes, 66, will pay $300 a month for her Medicare HMO premium next year, about double the current cost.

And she and her 63-year-old husband, disabled for a year, will have to buy a separate health-care policy for him.

Together they expect to pay $600 a month starting in January, compared with their current $130 bill. With a fixed income of about $21,000 a year, it’s a daunting increase.

“We are going to die early because we are worrying so much,” Fidel joked. “What can we do?”

The Ramirezes were among 50 seniors who attended an Oxnard session outlining changes to Medicare and Medicare HMOs for 2003. Ventura County Area Agency on Aging has been holding workshops across the county to prepare seniors for significant rate hikes.

Health-care costs have been rising sharply in recent years because of expensive new prescription drugs and diagnostic tests. Nationwide, employers were expecting rate hikes of 20% or more in 2003, according to a UCLA survey in June.

Medicare covers about 39 million senior citizens and disabled people. They will be among the hardest hit by cost increases because many are retired and on fixed incomes.

In Ventura County, costs for some Medicare HMOs will more than double.

Premiums for Blue Cross plans, for instance, will rise from $40 a month to $85. Secure Horizons is increasing to $65, compared with the current $50-a-month charge. Kaiser’s plan will change the least, but the group is not enrolling any new members until April 1, said Katharine Raley of the Area Agency on Aging.

Insurers are also raising co-payments and deductibles and reducing the level of benefits in many plans, Raley said. She told participants to shop carefully. It may make sense, for instance, for some seniors to consider a Medicare supplemental insurance plan, called a Medigap policy, which typically has higher premiums but no co-payments or deductibles, Raley said.

“You need to see how many services you think you will need and whether an HMO or a Medigap policy is the best choice,” Raley said. “You are going to be paying a lot more in hidden costs in an HMO than you have in the past.”

There are also many ways to cut the cost of prescription drugs, she said. Medicare does not cover medications, and private insurers usually limit what they will pay for.

But California allows Medicare recipients to purchase prescriptions that are listed on the state’s formulary at Medi-Cal prices, as much as 40% lower than retail. Costco offers competitive prices and does not require membership for its pharmacy, Raley said.

Some pharmaceutical companies offer steep discounts to low-income seniors. And bargains can be found on the Internet -- as long as consumers make sure the company they are dealing with is legitimate and offers drugs that are FDA-approved, Raley said. Prescriptions filled in Canada cost up to 70% less, she said.

Little House, a senior center in Ojai, can help find credible discounts. Audrey Brooks runs the volunteer program and can be reached at 640-3684.

The county’s Health Insurance Counseling and Advocacy Program also offers free information and assistance to those with Medicare, Medicare HMOs, Medigap policies and long-term insurance. To make an appointment, call 477-7310.

Several seniors who attended Raley’s Oxnard session said the information was useful. They said they would be able to save a few dollars or at least reduce cost increases.

But others were still anxious.

“So much for the golden years,” fretted one woman as she headed out the door.