 Data
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Data
Report
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Health Net provides
Medicare+Choice benefits to nearly 14,000 beneficiaries in these nine counties,
representing approximately 6 percent of Health Net's 224,000 total
Medicare+Choice members.
2002 Medicare+Choice
Changes
Beginning Jan. 1, 2002, Health Net of
California will stop offering Medicare+Choice individual and group products in
El Dorado, Marin, San Joaquin, Stanislaus and Ventura counties, affecting
approximately 8,900 beneficiaries.
In Riverside and San Bernardino counties, Health Net will stop offering an individual Medicare+Choice product, affecting approximately 2,600 individuals, but will continue to offer its group product through employer-sponsored plans.
In addition, Health Net of California will stop offering Medicare+Choice products in the northern and central portions of San Mateo County, affecting 2,000 beneficiaries; it will continue to offer the product in the southern portion of the county.
Health Net of the Northeast, formerly PHS Health Plans, will stop offering its individual and group Medicare+Choice products in New York County (Manhattan) in New York, affecting approximately 400 beneficiaries.
"Government reimbursement rates for Medicare+Choice are not keeping pace with rising health-care costs -- forcing us to again make tough and difficult decisions about our product offerings," said Jay Gellert, president and chief executive officer of Health Net Inc.
"We can participate in Medicare+Choice only in counties where reimbursement rates cover the costs of care and allow us to provide beneficiaries with a sufficient network of doctors and hospitals -- and where these doctors and hospitals want to participate in the program."
On average, Health Net's health-care costs for seniors are increasing by more than 10 percent this year, while the increase in government reimbursements is less than 3.2 percent for 2002. As a result, Health Net today also announced that it will reduce pharmacy and other benefits and increase supplemental premiums and co-payments in the counties where it continues to offer Medicare+Choice products in 2002.
"To continue participating in the Medicare+Choice program in 2002, it is necessary that we make changes in benefits and premiums," added Gellert. "Even with these changes, many seniors stay with Medicare+Choice plans since they still offer lower out-of-pocket costs and greater access to benefits, including some form of prescription drug coverage in many instances."
Health Net Inc. submitted its plans to the Centers for Medicare and Medicaid Services (CMS) on Monday, Sept. 17. Health Net is contacting affected Medicare beneficiaries, physicians and employer groups, notifying them of service area changes and providing them with information on other Medicare options.
Once the company receives approval from CMS, Health Net will notify its Medicare+Choice enrollees of 2002 benefit and premium changes. Notification will occur on or before Oct. 15, 2001.
Health Net is committed to working closely with
affected beneficiaries, physicians and hospitals to ensure a smooth transition
to another Medicare+Choice plan or back to traditional
Medicare.
2002 Medicare+Choice Service
Areas
In 2002, Health Net will continue to offer
Medicare+Choice products in 27 counties nationwide in the following
states:
| -- | Arizona: Maricopa (Phoenix), Pima (Tucson), Pinal and Santa Cruz counties; |
| -- | California: Alameda, Contra Costa, Kern, Los Angeles, Orange, Placer, Riverside/San Bernardino (employer-sponsored only), Sacramento, San Diego, San Francisco, San Mateo (partial county coverage), Santa Barbara, Santa Clara and Yolo counties; |
| -- | Connecticut: Fairfield, Hartford and New Haven counties; |
| -- | New York: Bronx, Kings, Queens and Richmond boroughs; and |
| -- | Pennsylvania: Philadelphia County |
Health Net Inc., formerly known as Foundation Health Systems Inc., is one of the nation's largest publicly traded managed health-care companies. Its mission is to enhance quality of life for its customers by offering products distinguished by their quality, service and affordability.
The company's HMO, insured PPO and government contracts subsidiaries provide health benefits to approximately 5.4 million individuals in 13 states through group, individual, Medicare, Medicaid and TRICARE programs.
Health Net's subsidiaries also offer managed health-care products related to behavioral health, dental, vision and prescription drugs, and offer managed health-care product coordination for multiregion employers and administrative services for medical groups and self-funded benefits programs.
For more information
on Health Net Inc., visit the company's Web site at http://www.health.net/.
The
matters discussed in this release contain forward-looking statements within the
meaning of Section 21E of the Securities Exchange Act of 1934, as amended, and
Section 27A of the Securities Act of 1933, as amended, that involve risks and
uncertainties. All statements other than statements of historical information
provided herein may be deemed to be forward-looking statements. Without limiting
the foregoing, the words "believes," "anticipates," "plans," "expects" and
similar expressions are intended to identify forward-looking statements. Factors
that could cause actual results to differ materially from those reflected in the
forward-looking statements include, but are not limited to, the risks discussed
in the "Cautionary Statements" section included within the company's most recent
Annual Report on Form 10-K filed with the Securities and Exchange Commission and
the risks discussed in the company's other filings with the SEC. Readers are
cautioned not to place undue reliance on these forward-looking statements, which
reflect management's analysis, judgment, belief or expectation only as of the
date hereof. The company undertakes no obligation to publicly revise these
forward-looking statements to reflect events or circumstances that arise after
the date hereof.