Humana Inc. is losing members in the Chicago area, even though it is the only Medicare HMO left in the region that offers drug coverage and other perks for seniors.
New federal statistics indicate Humana’s Medicare enrollment dropped 5 percent, or 3,349 members, in January and February. The plan had 69,516 seniors enrolled in Cook, Kane and Kendall counties in Illinois and Lake County, Ind., through the end of February, according to the Centers for Medicare and Medicaid Services.
The dip comes despite the fact Humana has no competition here among HMOs operating in Medicare’s managed-care program, an ambitious but troubled government effort to provide the elderly with the traditional health coverage plus such extras as drugs and preventive care.
Last year, United HealthCare of Illinois Inc. joined dozens of plans nationwide pulling out of the program, leaving more than 33,000 Chicago-area seniors without some benefits. The insurer is a subsidiary of Minneapolis-based UnitedHealth Group.
Louisville-based Humana decided to remain in the Medicare business here but opted to raise seniors’ out-of-pocket costs and pare some benefits.
Humana said there could be several reasons for the enrollment drop, including higher premiums or decisions by some providers to end their relationships with the insurer.
Furthermore, Humana said it didn’t benefit from United’s pullout because the two insurers had different networks of doctors. Seniors in United’s plan apparently weren’t willing to switch doctors to gain benefits offered by Humana.
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HMOs are able to offer more perks than other insurers because, in part, they restrict doctor and hospital choices to their networks.
“The physicians and [health plan] members’ relationship is a strong one,” said David Jarboe, president of Humana’s Chicago market.
Humana said its other health options in Chicago are growing. Its new sales subsidiary, Marketpoint, last year began marketing a variety of benefit plans to seniors and other consumers.
Marketpoint sold 3,500 policies to seniors in January and February that offered Medicare beneficiaries supplemental benefits, Jarboe said.
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