The December 3 "Ask Angelia" column sought answers for a reader about why Prisma Health would promote one health plan (Aetna Medicare Prime) over others and whether the healthcare system aimed to restrict Medicare patients’ choices of health plans?
I received five emails in response to that column. Some readers said the answer was "unresponsive" and didn't really answer the question. For others, the column triggered other questions.
Read the column: Ask Angelia: Why is Prisma promoting one health plan over others?
I reached out to Prisma Health's spokesperson again, sharing the sentiment I'd received from readers, and asking the same questions that appeared in the December 3 column along with the following:
Does the Aetna Medicare insurance plan being promoted by Prisma limit the hospitals the insured person can go to? Does Prisma accept Cigna Medicare Advantage and are they in-Network? Has Prisma said it will not accept AARP/United Healthcare?
Below are the responses.
"Prisma Health accepts most major insurances plans. Consumers can find the accepted insurance plans on the Prisma Health website: https://prismahealth.org/patients-and-guests/bill-pay/accepted-health-insurance," Sandy Dees, Prisma Health spokesperson, said in an email.
"Because each insurance plan is different, questions related to coverage should be addressed to the insurance carrier," she said.
I also contacted Ethan Slavin, a spokesperson for Aetna, a CVS company.
I asked him this question from a reader, "Does the Aetna Medicare Insurance Plan being promoted by Prisma limit the hospitals the insured person can go to?"
His answer, via email, was "Yes, the network was designed in coordination with Prisma Health, including local physician leaders and facilities listed here."
He also shared a link to a press release about the collaboration between Prisma and the Aetna Medicare Prime Plan (HMO-POS), posted October 19, 2021 on the Prisma Health website. You can read it in its entirety here.
The plan was offered during the Medicare Annual Enrollment Period between October 15 and December 7, 2021. It was made available to the 460,000 individuals eligible for Medicare in much of the Upstate and Midlands regions of South Carolina, the press release said.
Shawn Armstrong, senior vice president, payor strategies and value based care, at Prisma Health, said in the release that "the Aetna Medicare Prime Plan (HMO-POS) was designed based on insights from Prisma Health physician leaders who understand our community and who have deepened the level of trust with our patients and the communities where they live.
"Both Aetna and Prisma Health believe that a national insurance carrier and a local physician network working together can improve quality, make the health care experience easier, make health care more efficient and reduce health care costs. We’re looking forward to this new collaboration."
Molly Schild, chief medicare officer for Aetna in South Carolina, said in the release that the Aetna Medicare Prime Plan was designed specifically with Prisma Health patients in mind, in collaboration with Prisma Health clinicians and leaders. and is an option for patients currently on Medicare Advantage or Original Medicare.
"This plan allows them to keep their Prisma Health doctor while enjoying potentially richer benefits and lower out-of-pocket costs," Schild said.
Do you have a question you want answered? Send it to me at firstname.lastname@example.org or via mail to Angelia Davis, 32 E. Broad St., Greenville, SC 29601.
This article originally appeared on Greenville News: Ask Angelia: Readers question Prisma promoted, accepted plans