The Enid News and Eagle, Enid, OK

Local and State News

March 29, 2013

Florida raid takes down health plan

ENID, Okla. — After a raid on a health insurance company headquartered in Florida, 126 northwest Oklahomans need to select new Medicare Advantage and prescription drug insurance providers.

On Thursday, FBI agents and Department of Health and Human Services executed search warrants at the home office of Universal Health Care, which sold “Universal Any, Any, Any” Medicare Advantage plans, with and without prescription drug coverage, in Oklahoma and other southern states. The Florida Department of Insurance Regulation accused Universal of financial irregularities, including possible fraud. Universal already is in the process of liquidation.

Oklahomans covered by the Universal Any, Any, Any plan automatically will be switched to original Medicare and a new prescription drug plan Monday, with coverage effective immediately, said Ray Walker, director of the Medicare Assistance division of Oklahoma Insurance Department.

Customers who want to choose the plan that best fits them have two options.

“If they call 1-800-MEDICARE over the weekend, the change will be effective April 1,” Walker said.

That phone is answered 24 hours a day, Walker said.

If they want to speak to someone about an insurance assistance program in Oklahoma, they can call a local or statewide agency Monday or later to select their plan. In that scenario, they will have original Medicare and the drug policy selected on their behalf during the month of April, then the plan they choose on the first of the month after they make their own choice.

OID’s Medicare Assistance Program can explain the options and help with enrollment from 8 a.m. to 5 p.m. Monday to Friday. The counseling is available by calling (800) 763-2828.

Plans selected after Monday will go into effect May 1. The deadline for all changes is May 31.

All Universal customers will be sent two letters after Monday. One letter will come from the Centers for Medicare and Medicaid Services explaining their options for health care coverage. The other letter will come from the state of Florida, explaining the allegations against Universal.

“Both the letters are going to tell them the company has gone bankrupt and as of April 1, they no longer exist,” Walker said. “Claims incurred in March will be paid just as they were while that person had Universal coverage. They will only pay what they paid while they had Universal coverage.”

Walker said if a medical provider tries to collect the full amount of the bill directly from people who carried Universal insurance, they should call (800) MEDICARE and report that.

“Providers are also being contacted,” Walker said. “They are also being told what they can and cannot do.”

Walker pointed to differences in what drug plans cover. Those who are moved to a drug plan by CMS might not end up with the plan that’s best for them.

“We still want all of these beneficiaries to call us in Oklahoma City or call (NODA Area Agency on Aging) and get enrolled in the best drug plan for them,” Walker said.

Another option available to help people on Medicare is a Medicare supplement plan, also known as “Medigap” plans, which pay the balance, Walker said.

Walker said supplement plans are standardized, with 10 different plans available in Oklahoma.

“The main thing is not to panic,” Walker said. “It will all get straightened out, and their claims will get paid. If it’s a legitimate claim that would have been paid, it will be paid. They only have to pay the copay or coinsurance amount they would have had to pay.”

The phone number for the state insurance department’s Medicare Assistance Program is (800) 763-2828.

Residents of Alfalfa, Blaine, Garfield, Grant, Kay, Kingfisher, Major and Noble Counties can call NODA Area Agency on Aging at (580) 237-2236 for assistance.

Residents of Wood and Woodward counties can call Oklahoma Economic Development Authority at (800) 658-2844.

Universal appears not to be headed for resuming business. One of the pages on the company’s website reads, “As of Friday, 8 a.m. EST, office will remain closed, with the exception of Member Services, Case Management, and Pharmacy Representatives. These departments should report to work as scheduled. Please enter through the front door. For all other employees, please check back on Monday morning regarding the process for returning company property and collecting your personal belongings.”

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