Erickson Tribune

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UPDATED: Wednesday, January 30, 2008

A better way to spend Medicare’s money

Posted on Wednesday, January 30, 2008
 

By Lisa M. Davila
THE ERICKSON TRIBUNE

If you are 65 or over, you probably know something about Medicare. Like what it does and doesn’t cover and how supplemental health insurance is often needed to make up for gaps in health coverage.

You also may have heard about Medicare Advantage plans, and you might be wondering how they differ from Original Medicare and supplemental plans.

Medicare Advantage plans: a case study
A Medicare Advantage plan is formed when a health insurance company contracts with Medicare to provide health care benefits to Medicare beneficiaries, with the idea that private companies can often provide the same or better health care at a lower cost.

That’s how Erickson Advantage® came about. “Erickson Advantage was created because of President and CEO John Erickson’s desire to provide quality low-cost health insurance to our residents,” says Dorothy Schulz, health insurance resource manager at Charlestown, an Erickson- built and -managed community in Baltimore, Md.

Erickson Advantage focuses on health care and low member cost. “The Erickson Advantage philosophy  is first about keeping residents as healthy and independent as long as possible,” Schulz says. “In addition, we realized that our residents were paying $200-$300 a month for Medicare supplemental health insurance policies. We thought we could offer better health insurance at lower prices.”

It took time and research to develop just the right plan. “We worked with  Medicare for two years before the plan was approved. Erickson Advantage is tailored for residents—we asked residents what they wanted and what would be beneficial to them, and we designed the health insurance plans around their wants and needs,” Schulz says.


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How Erickson Advantage stands out
Erickson Advantage is different, even before you sign up. Erickson residents can trust that their health insurance resource manager won’t recommend Erickson Advantage if it’s not the best plan for that resident. “My job is to find out what a resident’s health insurance is, and if they don’t know details, I call their insurance company so I can do an accurate comparison,” Schulz says. “I match benefit for benefit. Then we talk about cost. If they have better health insurance, I point out the differences. And if I think that Erickson Advantage is  better,  I tell them why.”

Erickson Advantage has real people on-site to serve members. There’s a nurse care coordinator available who can be another set of eyes and ears for family members—many of whom live out of state. Schulz says, “I’ll ask residents how many of them have had a call from someone at their health insurance company just to ask how they’re doing—because they’re going to get a call from us. We really want to know how they’re feeling.”

Care coordinators do more than just call to check on members. “Our care coordinators meet with residents one-on-one,” Schulz says. “They talk about lifestyle—diet and exercise, and health conditions. The resident learns about how health conditions affect them and what steps they can take to control a condition. Together they create a care plan that addresses the resident’s particular needs.”

But what really sets Erickson Advantage apart is the health care coverage and benefits. “We understand that sometimes older adults have certain medical  conditions,  and we help them maintain their optimum state of health for as long as possible,” Schulz says. “All of our preventive services are at no extra cost, which encourages residents to use those services. And if there are going to be health issues, we can find them sooner rather than later.”

Making a health plan even better
Providing older adults with a health insurance plan that emphasizes preventive care has yielded impressive results. The length of stay in hospitals for Erickson Advantage members is 3.9 days versus Medicare’s average length of stay of  5.9 days. And the Erickson Advantage skilled nursing facility length of stay is 11.73 days versus the traditional Medicare average length of stay of 25 days.¹

Research continues into how to make Erickson Advantage even better. “By asking residents what they want, that’s how we heard about the interest in, for example, a dental benefit*,” Schulz says. “We also are offering benefits that are geared toward encouraging fitness and fall prevention for 2008.”

For more information, call the community nearest you at 1-800-380-6211.

You must have Medicare Parts A and B, and must reside in the service area of the plan.


*limits and copays apply

¹Erickson Advantage 3rd quarter utilization summary

Erickson Advantage® is a Medicare Advantage demonstration project administered by Evercare®, offered by United HealthCare Insurance Company, a Medicare Advantage organization with a Medicare contract M0011_071217CG05.



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