Great Plains Health
North Platte, Neb., November 26, 2024 – Great Plains Health patients who hold a Medicare Advantage Plan can now easily switch to Traditional Medicare, thanks to a Special Enrollment Period (SEP) and guaranteed issue rights granted by the Centers for Medicare and Medicaid Services (CMS) and confirmed by the Nebraska Department of Insurance.
The SEP applies to Medicare Advantage plan holders receiving care at Great Plains Health from the following insurers:
- Aetna
- Centene Health/Nebraska Total Care
- Blue Cross/Blue Shield of Nebraska
This SEP includes guaranteed issue rights for a Medigap plan, allowing plan holders to disenroll from their Medicare Advantage plan and enroll in Traditional Medicare (also referred to as Original Medicare) without penalty or medical underwriting.
Key details about the SEP are as follows:
- The SEP applies to patients assigned to, currently receiving care from, or who have received care in the past three months from a Great Plains Health provider or clinic.
- Most affected plan holders have until January 31, 2025, to make the switch.
- Those wishing to explore their options should contact their local insurance agent, Medicare at 1.800.MEDICARE, or the State Health Insurance Assistance Program (SHIP) at 1.877.839.2675 as soon as possible to make their switch.
The SEP is specific to Medicare Advantage plan holders. The standard Medicare Open Enrollment period, which ends on December 7, 2024, still applies to those not enrolled in Medicare Advantage.
As first shared in May, the Great Plains Health Innovation Network (GPHIN), the clinically-integrated network that includes GPHealth clinics and many independent practices in the area, will no longer be in-network for any Medicare Advantage plan, including the three plans that are currently accepted at Great Plains Health, effective January 1, 2025. This transition is largely because of concerns with delays and denials in care.
“We believe it is in the best interest of our community to no longer accept Medicare Advantage plans. Our Chief Nursing Officer’s parents had the option to be on a Medicare Advantage plan. She met with an independent insurance agent and helped her parents enroll in Traditional Medicare. As a nurse, she has firsthand knowledge of the delays and denials of care with Medicare Advantage. This change saved her parents money and provides peace of mind. We are treating our family members the same way we want our community to be treated,” said Dr. Narayana Koduri, Chief Medical Officer, Great Plains Health; Ivan Mitchell, CEO, Great Plains Health; and Lindsay Pedersen, Chairman, Great Plains Health Board of Directors.
Railroad retirees have a specific option for coverage – GA-23111 PLAN F – an employer-sponsored Medicare supplement offered by Iron Road Healthcare and UnitedHealthcare. This plan will be accepted at Great Plains Health in 2025, with open enrollment running from November 1 to December 31, 2024. Note that GA-23111 PLAN F is not a shoppable plan.
Emergency care will always be available to all patients, regardless of insurance status or ability to pay. In 2025, Great Plains Health will remain in-network with two D-SNP plans: Molina D-SNP and Nebraska Total Care WellCare D-SNP.
Great Plains Health recommends Traditional Medicare and GA-23111 PLAN F for railroad retirees. Traditional Medicare is always accepted at Great Plains Health and other facilities across Nebraska and the United States.
For more information, including FAQs and resources, visit gphealth.org/yourlocalcare.