Wednesday, August 16, 2017

Insurance company specializing in low-income customers to cover rural areas in Nevada, Ohio and Missouri that had no 2018 insurers

"Gov. Brian Sandoval announced an agreement with a Missouri-based company Tuesday to make sure health insurance is available to 8,000 rural Nevadans who faced the loss of their coverage after Anthem Blue Cross and Blue Shield pulled out of the state's healthcare exchange," the Associated Press reports. Prominence HealthFirst, which was the only other statewide carrier in Nevada's exchange, had withdrawn earlier.

Centene Corp. will partner with Nevada-based Hometown Health to ensure all areas of the state receive coverage. Centene's Nevada subsidiary will be called SilverSummit, and will provide statewide coverage through the Silver State Healthcare Insurance Exchange. About 8,000 rural residents in 14 of those counties would have had no available health insurance options in 2018. Anthem announced it was pulling out of all but the three most populous counties in Nevada because it was unsure whether President Trump would continue to pay it the cost-sharing subsidies that make it possible to offer certain low-cost plans on the healthcare marketplace.

Bloomberg map (click to enlarge)
Centene is expanding in other states with similar coverage gaps: the company plans to offer policies next year in 25 Missouri counties and 20 Ohio counties that also faced having no marketplace options. "Centene Corp. covers 1.2 million customers through the exchanges and is one of the biggest insurers in that market," the Toledo Blade reports. "The insurer specializes in managing the state and federally funded Medicaid program for the poor. On the exchanges, it markets to low-income customers in areas where it has already formed networks of providers for its Medicaid business. The insurer uses narrow coverage networks that steer customers to doctors and hospitals near where they live but often exclude high-cost health care systems." The structure of the Centene plans means that patients who need expensive, specialized care may face much higher bills or not be covered for needed treatments at all.

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