PARK, TELLER, and FREMONT COUNTIES, Colo. — Kaiser Permanente announced that it is pulling health care coverage for roughly 1500 people in Teller, Fremont, and Park Counties as of Dec. 31, 2019.
This means most are also losing their primary care doctors and specialists, some of whom they’ve been seeing for decades. These physicians and specialists are suddenly out of network.
Those losing health care coverage were alerted of loss of coverage with the following document provided to us from Kaiser Permanente.
Kaiser did not want to talk on-camera, however, they did provide the statement below:
“Kaiser Permanente Colorado has been serving communities in southern Colorado for nearly 25 years and remains committed to serving its members in this area of the state. This commitment includes recently opening a new medical office in Pueblo and the announcement of a third location in Colorado Springs set to open in 2021. Like any business, we regularly evaluate how we operate and make necessary adjustments to make sure we remain competitive. Kaiser Permanente has a small Medicare member population in Teller, Fremont and Park counties, and it has become increasingly challenging to operate where we do not have a large presence. After careful review, we will no longer provide Medicare coverage in Teller, Fremont, and Park counties. We apologize for this inconvenience and are working with our current Medicare members in these counties to transition them to a new Medicare health plan for 2020. There are several carriers in these counties who can provide comparable benefits.”
The Problem Solvers also asked the Colorado Division of Insurance what rules or State laws would govern this type of decision. We were told the State does not control or regulate Medicare in any way. The Centers for Medicare and Medicaid also told the Problem Solvers there is nothing wrong with what Kaiser is doing.
The Centers for Medicare and Medicaid also declined an on-camera interview, however, they did provide a statement saying that it “allows plans to submit non-renewal or service area reductions.”
Here is the full list of questions and answers from CMS.