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Humana returns services to county

A Medicare HMO company that abandoned Hernando County 3{ years ago is back.

In 2000, Humana was one of the county's two Medicare HMO companies to pull out, leaving Medicare beneficiaries frightened that they'd have no choice for prescription drug coverage. That crisis was alleviated that same year, when two new companies stepped into the county.

At the time, Humana blamed its departure on declining federal reimbursement rates for their services and the lack of competition from doctors and hospitals to secure better prices.

Humana said Tuesday that its renewed interest in Hernando County coincides with better federal reimbursement rates, as well as some internal company improvements.

"We have gotten better at creating a sustainable network," Humana spokeswoman Valerie Kennedy said.

Hernando County is an attractive place for Medicare HMO industry these days. Humana marks the fifth company to offer Medicare HMO benefits in the county.

The interest is due in part to increases in the federal government's reimbursement rates. In 2003, the average monthly Medicare payment to Medicare HMO companies for people 65 and over in Hernando County was $582. In 2004, the monthly average rose to $708, a 21.6 percent increase, which was the biggest jump in the Tampa Bay area, according to information gathered by the federal Centers for Medicare and Medicaid Services.

And while many in the county are elated at all the choices, those who remember the local Medicare HMO crisis of 2000 are leery of Humana, said Marie Nielsen, vice president of Florida Citizens to Keep HMOs, a watchdog group formed in Spring Hill during the Medicare HMO crisis.

Nielsen has spoken with a number of Spring Hill seniors who have already been contacted by Humana sales representatives.

"People now have a choice, which is good," Nielsen said. "But whether or not they're going to trust Humana again is the question."

The benefits Humana is offering today are about to change in a few weeks, Kennedy said.

The company, like all HMO Medicare companies nationwide, has until Jan. 30 to upgrade its benefits and reduce premiums and copayments to take advantage of recent federal legislation that gives them more lucrative reimbursement rates, according to the federal government. The new plans would go into effect March 1.

Currently, Humana is offering generic prescription drug coverage with copayments starting at $7 with no limits on the amount of drugs covered per year. The plan does not cover brand-name drugs, according to the company.

Humana's hospital inpatient copayment is $200 a day for the first five days, and it pays 100 percent after five days. The maximum out-of-pocket charge for members is $2,560 per year.

Visits to primary care physicians carry a $5 copayment while specialist visits have a $35 copayment.

Also, the company offers Medicare beneficiaries gym membership to the Hernando County YMCA through its "Silver Sneaker" program, which is available through some of its plans.

For more information about benefits, call Humana at 1-800-833-6578.

_ Staff writer Stephen Nohlgren contributed to this report.