Local doctors affiliated with Mercy Health work with insurer to create innovative option for health care and coverage
Health Alliance Plan (HAP), a Michigan-based nonprofit health plan, has partnered with a group of West Michigan physicians affiliated with Mercy Health to create a new Medicare Advantage plan tailored specifically for West Michigan residents. Developed in collaboration with these physicians, HAP Choice Medicare is an HMO plan available in Kent, Muskegon, Oceana and Ottawa counties, making it HAP’s first Medicare product to be offered in West Michigan.
There are two plans from which to choose: one with a $0 premium and the other with a $26 monthly premium. Both plans offer $0 deductibles, as well as $0 copays for primary care physician visits, outpatient diagnostic lab tests, annual physical, routine eye exams and hearing exams. Both plans also offer optional dental coverage, which comes with a $0 deductible and which covers diagnostic and preventive services at 100%.
“Our providers worked together with HAP to identify the most critical care needs of our Medicare-eligible patients,” said Kristen Brown, MD, president of Mercy Health Physician Partners. “Because these physicians are on the front lines of providing care, they understand the importance of offering an affordable health plan that covers the types of care this population needs to maintain optimum health and independence.”
HAP teamed with a group of Mercy Health-affiliated physicians that included a geriatrician, family practice physician and palliative care provider, along with other primary care providers and specialists, to design these plans with the needs of their patients in mind. With HAP Choice Medicare, care is coordinated by a primary care physician, who has the flexibility to refer patients to any specialist in the HAP Choice network.
“As a physician, I understand the trusted relationship between doctors and their patients,” said Michael Genord, MD, interim president and CEO of HAP. “Removing barriers to care is very important to HAP because we want our members to have easy access to the primary care, tests, screenings and specialty care they need. HAP Choice Medicare gives them this access, along with the confidence of knowing their care is being managed by their own primary care physician.”
HAP Choice Medicare provides members with an over-the-counter allowance of up to $100 per quarter that can be used on items needed to maintain a healthy lifestyle such as bandages, aspirin, blood pressure monitors and diabetic socks.
The plan also offers $0 cardiac and pulmonary rehab visits, as well as $0 physical therapy, occupational therapy and speech therapy visits and $0 behavioral health and substance abuse visits. In addition, members have 24/7 access to telehealth programs for immediate consultation and $0 gym membership through Silver&Fit.
Medical coverage for “snowbirds” who make extended trips to Florida, Arizona or Texas, as well as those who spend significant time in northern Michigan is also part of the HAP Choice Medicare plan. For members who have a seasonal home in these areas, coverage is the same as it would be at home.
With HAP Choice Medicare, four popular drugs used to manage diabetes are covered as Tier 1 drugs, and insulin is covered as a Tier 2 generic drug rather than a higher-tiered copay. And with this plan, most members who use Medicare Part D for prescription drug coverage will be eligible to have their Tier 1 and Tier 2 generic drug copays continue through the coverage gap (donut hole).
HAP offers a variety of Medicare options throughout the state, which vary by county. In 2019, HAP’s Medicare Advantage HMO scored highest among Michigan Medicare Advantage plans in the Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey, which asks patients to report on their health care experiences.
The Annual Enrollment Period for Medicare runs through December 7. Physicians affiliated with Mercy Health who participate in HAP Choice Medicare may also contract with other Medicare Advantage plan sponsors.
About Mercy Health and Mercy Health Physician Partners
Mercy Health is a regional, multi-campus Catholic health care system serving West Michigan and the lakeshore with four hospital campuses, more than 90 physician offices, more than 1,300 medical staff physicians, more than 800 hospital beds and more than 9,000 colleagues, and hospice, home health and long-term care service offerings. Mercy Health Physician Partners, our multi-specialty medical group, employs more than 800 physicians and advanced practice professionals in Grand Rapids, Muskegon, Holland and the lakeshore. Mercy Health has annual operating revenues of about $1.4 billion and returns about $80 million to its communities annually through charity care and community benefit programs. Mercy Health, a member of Trinity Health, is committed to being a trusted health partner for life, transforming the communities we serve by providing high-quality care that is the most accessible, compassionate and personalized in West Michigan. Visit us at www.MercyHealth.com.
About Health Alliance Plan
Health Alliance Plan (HAP) is a Michigan-based, nonprofit health plan that provides health coverage to individuals and companies of all sizes. For nearly 60 years, HAP has partnered with leading doctors and hospitals, employers and community organizations to enhance the health and well-being of the lives it touches. HAP offers a product portfolio with six distinct product lines: Group Insured Commercial, Individual, Medicare, Medicaid (using the HAP Empowered name), Self-Funded and Network Leasing. HAP excels in delivering award-winning preventive services, disease management and wellness programs, as well as personalized customer service.