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6:42 PM Tue, Oct. 23rd

Seniors continue to have health care choices--if they are willing to pay w/art<BR><BR>

Thousands of Medicare recipients in Mohave County lost their only health maintenance organization late last fall with the collapse of Premier Healthcare of Arizona, and that trend toward fewer HMO choices is continuing statewide.

Since 1998, 54,200 residents of rural Arizona have been pushed from the federal health insurance program, and about 13,000 Arizona seniors will lose Medicare HMO coverage Jan.

1 as insurance companies drop less-profitable rural regions.

The latest wave means that Santa Cruz County will be the only rural county in the state with a Medicare + Choice HMO.

Santa Cruz joins Pima and Maricopa counties as the only ones out of 15 in the state that continue to provide the senior HMO plan, said Martha Taylor, coordinator of the state Health Insurance Assistance Program in Phoenix.

And while that trend is continuing, seniors here do have choices beyond Medicare parts A and B, the traditional fee-for-service programs.

Part A covers hospital stays, home health care, skilled nursing and hospices, and Part B covers doctor visits, lab work, outpatient surgery, ambulance trips and emergency room care.

Seniors in Mohave and other counties may opt to buy supplemental plans that cover deductibles not provided by Medicare parts A and B, Taylor said.

However, she acknowledged that Plan C, at about $125 a month per Medicare recipient, may be too expensive for many seniors, and does not cover prescriptions.

Kingman resident Ruth Vest said she pays $154 a month for Plan F, which covers parts A and B deductibles, basic benefits, the co-insurance deductibles for extended stays in skilled nursing homes and foreign travel emergencies.

"If you don't have a supplemental, you are paying all that money for doctors," Vest said.

"You have to pay 20 percent for hospitalization."

She said her policy provides a discount card for insurance, adding that her arthritis medication costs $129.88 for 60 pills, a month's supply.

"We are fortunate enough to have enough money to buy the prescriptions, but how many people here in Kingman can afford to buy all the prescriptions?" Vest asked.

Kingman diabetic Vincent Giglio said his six-week supply of insulin costs $68, adding syringes come to an additional $28 for the same time frame.

"My (apartment) complex where I live, they lowered my rent from $233 to $150 (per month) so I can help pay for my medication," Giglio said.

Giglio, a 76-year-old retired clothing designer who is also legally blind, said he cannot afford $125 a month for supplemental coverage.

However, he said he plans to contact insurance agents to find out what is available.

Seniors with incomes up to 35 percent above the federal poverty level are eligible for state assistance with their Part B coverage, Taylor said.

The Social Security Administration now deducts $45.50 per month from Social Security checks to cover Part B.

Financial qualifications for the assistance are up to $716 per month for an single seniors and a maximum of $958 per month for couples, Taylor said.

"I know there are a lot of people out there who do (qualify) and don1t even know about it," Taylor said.

Taylor said one insurance company has expressed interest in providing a fee-for-service plan in rural Arizona, but has ruled out Mohave County.

Meanwhile, semi-retired insurance agent John Gilbert of Kingman remains pessimistic about a senior HMO entering Mohave County to fill Premier's void.

"I always felt that nature abhors a vacuum, and industry or the free market abhors a market not being served," he said.

"From that standpoint, I would think that the HMO will come.

But it is only going to come after pressure is put on Congress by the seniors to take care of the problem."

Premier1s collapse has not hurt hospital stays at Kingman Regional Medical Center, chief executive officer Brian Turney said.

Admissions of seniors rose from 3,717 people from July 1, 1998, through June 30, 1999, to 3,785 for the fiscal year ending June 30, he said.

Seniors account for about half of the admissions in the 124-bed hospital.

The Associated Press contributed to this report.