Grand Valley seniors using Rocky Mountain Health Plans could be faced with a surprise during their next visit to Community Hospital

Grand Valley seniors using Rocky Mountain Health Plans could be facing a surprise during their...
Grand Valley seniors using Rocky Mountain Health Plans could be facing a surprise during their next visit to Community Hospital(Yzabelah Roberts)
Published: Dec. 14, 2020 at 7:30 PM MST
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GRAND JUNCTION, Colo. (KKCO) -

Seniors around the valley could be getting a big surprise at the doctor’s office come January 1st if they don’t read the fine print on their insurance.

This year, Community Hospital was not able to sign a contract with Rocky Mountain Health Plans and make a deal, meaning their patients will have until December 31st to change plans or face fees not covered by Medicare, “so unfortunately, we didn’t start negotiating for the 2021 plan until October of this year,” says Chris Thomas, CEO Community Hospital

Medicare is cancelling the grandfather clause that allows Rocky Mountain Health Plans’ members to continue using the cost plan.

A cost plan is Medicare in addition to a private company—it’s now being taken over by advantage and medigap plans in Mesa County.

“So I called community and they said well we haven’t officially signed up yet, but wait a month or so and everything should be okay,” says Art Minjarez, a Mesa County Resident who has been talking with Community Hospital about the contract on behalf of his mother.

“That puts seniors at a pretty big disadvantage not having enough time frame so we tried very hard with patients that have chosen Community Hospital, we sent out letters, we made some calls to try to let them know that negotiations didn’t come to fruition and we hope that they’d have time to select another,” says Thomas about Community Hospital’s efforts to communicate with patients about the decision not to move forward with Rocky Mountain Health Plans.

People insured with Rocky Mountain who use services at Community Hospital will no longer be covered for anything, but emergency services as they are out of network.

St. Mary’s Hospital patients will still be covered on the new Rocky Mountain advantage plan because they are in network.

Cost plans have been getting eliminated throughout the U.S. as more and more advantage plans make their way to those areas.

Approximately 5,000 people in the valley will lose their cost plan on December 31st.

“They can change up to March, but most people are going to want to have it in place by January 1st, so they could literally sign up by December 31st and have it go into force January 1st,” says Stephen Cole, owner of New Horizon Insurance Agency who has been working with people to explain the situation.

The next enrollment period to change an advantage plan is January 1st through March 31st.

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