Published Wednesday, September 25, 2002
Herald Business Editor
Seniors in Mercer County with a Highmark Blue Cross/Blue Shield Medicare HMO could see no premium increase on the insurers' most popular product next year and a relatively mild 3 percent hike on another product.
Last year seniors in the county got socked with up to a 130 percent hike with cuts in benefits from the non-profit Pittsburgh health maintenance organization.
"We didn't want seniors in the rural counties to see the increases they've had in the past,'' said Vanessa Paris, a Highmark spokeswoman. "Last year Mercer County received higher increases than any of our other counties. We're committed to holding increases down.''
All benefits in both insurance plans will remain unchanged next year for Mercer County seniors, she said.
Highmark filed its request with The Centers for Medicare and Medicaid Services. Agency approval is expected next month with the new rates to become effective Jan. 1.
Seniors in counties surrounding Pittsburgh including Lawrence County could see their rates triple for Highmark's most inexpensive plan. Still, seniors in Mercer County would pay nearly three times as much for the same plan because the federal center has designated the county as rural. That gives insurers a lower reimbursement rate on the philosophy that health care costs less than it does in metropolitan areas.
Mercer and Crawford counties will continue to be labeled rural while Erie County received a metropolitan designation last year.
With a top market share in health-care insurance in western Pennsylvania, Highmark's actions often have far-reaching effects. Nearly 5,000 Mercer County seniors have a Medicare HMO through Highmark making the company the top insurer here.
Highmark markets its senior insurance products under the brand name SecurityBlue.
SecurityBlue Basic, which is the company's least expensive plan, would continue to have the same $99 monthly premium next year for Mercer County residents. The deluxe plan, SecurityBlue Standard which has prescription drug coverage, would increase to $139 from $135.
In Allegheny and the 11 surrounding counties, the cost for SecurityBlue Basic would increase from $12 to $36 monthly, according to the company, while the standard plan would rise 49 percent from $65 to $97 per month.
Other Medicare HMO companies in the region -- Health America's Advantra and UPMC Health Plan's UPMC for Life -- have yet to announce rate plans for 2003.