Medicare patients fill helplines with questions about Highmark-UPMC feud

Since August 2018, about 60 percent of calls answered by officials with the Allegheny County Department of Aging concerned how a dispute between Pittsburgh rivals Highmark Health and UPMC will affect seniors' Medicare Advantage coverage, according to Trib Live.

Here are four things to know:

1. A state-brokered consent decree between Highmark and UPMC expires June 30, 2019. Afterward, Highmark Medicare Advantage members will be unable to access several UPMC providers and hospitals at in-network rates. Ten UPMC hospitals are slated to go out of network with Highmark in 2019.

2. In addition, beginning in July, Highmark MA members will have to pay any estimated upfront charges for nonemergent treatment in full before accessing care from most UPMC providers, UPMC said in an Oct. 1 internal memo.

3. Many seniors are anxiously anticipating the changes and expressing concern to county officials. For example, some are wondering whether they'll be able to keep their Highmark Health-owned Allegheny Health Network providers and still get affordable care with UPMC specialists.

4. The confusion comes as Medicare open enrollment kicks off Oct. 15, and some seniors may need to change health insurance plans to maintain in-network access to their providers.

More articles on payers:
Health insurers regaining pre-ACA profitability: 3 things to know
The 10 UPMC hospitals going out of network with Highmark in 2019
Immigrants pay more for premiums than they get in health benefits, study says

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