September 23, 2023

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SLO County seniors lose Medicare health plan coverage


Courtesy of AARP

Morro Bay resident George Garrigues obtained sudden information when a letter arrived in the mail, informing him that he has right until Aug. 1 to obtain a new Medicare insurance policy service provider.

“It was a surprise,” the retired journalism professor reported. “And August is not too significantly away.”

Garrigues, who is 90 years outdated, enrolled in the Golden Condition Medicare Overall health Program when he moved to San Luis Obispo County soon after decades employing the Kaiser Permanente technique.

The California Division of Managed Well being Treatment, the state agency governing managed wellness care plans, requested Golden State Medicare Health Plan to close all present contracts with existing consumers on or in advance of June 1, with Medicare protection ending on August 1, according to a settlement arrangement dated February 2022.

The essential rationale Golden Point out Medicare Overall health System dropped its Medicare license was its failure to maintain excellent money standing. The health prepare was functioning at a deficit of around $35 million as of December 2021, according to the settlement settlement.

“Given (Golden State Medicare Overall health Strategy)‘s dire economic ailment and its apparent inability to work its business in a fashion to allow it to comply with even the bare minimum fiscal necessities of all (condition) licensees, revocation of (its) health strategy license is acceptable and urgent,” according to a July 2021 courtroom filing outlining the accusations towards Golden Condition.

The Golden State Medicare Well being Program serviced about 4,966 customers as of April 2021, in accordance to the July 2021 court docket submitting.

Clientele of Golden Point out ended up unfold throughout 8 California counties, including San Luis Obispo, in accordance to a 2022 summary of added benefits.

Seniors with Golden Point out Medicare Wellness Strategy lookup for new coverage

Garrigues advised The Tribune that when he selected the Golden Point out Medicare Health System, he didn’t meet up with with a Health Insurance Counseling & Advocacy Program (HICAP) service provider very first.

HICAP is a statewide network of nonprofit businesses that are licensed to deliver unbiased facts about Medicare alternatives to seniors.

But now that his Medicare protection is staying discontinued, Garrigues said he wanted to know his health and fitness system options.

Garrigues explained he referred to as several HICAP agencies but it was tricky to get an appointment.

He drove from Morro Bay to the Central Coastline Fee for Senior Citizens office environment in Santa Maria, which serves San Luis Obispo and Santa Barbara counties, to talk about wellbeing programs on Wednesday.

During his appointment, the HICAP advisor reviewed various health and fitness plan options with Garrigues and served him make a choice about the approach that greatest suits his demands, he mentioned.

By the time his appointment was in excess of, Garrigues decided on a new Medicare health and fitness plan.

SLO County inhabitants with inquiries about the suspension of the Golden State Medicare Wellness Strategy, or other health insurance inquiries, can make an appointment with a SLO County HICAP supplier by calling 805-928-5663 or traveling to

This tale was originally revealed June 22, 2022 2:13 PM.

Linked tales from San Luis Obispo Tribune

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