BOS Takes Action Towards Failure of Health Care Companies to Provide Medicare Prescription Plan for Elderly


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Imperial Valley only county without MAPD coverage in state

EL CENTRO – The Board of Supervisors engaged in a lengthy discussion with Gary Wyatt, Director of Intergovernmental Relations, and Medicare/Medi-Cal specialists Maria Schimer and Raymond Dawson, regarding the failure of Molina Healthcare to provide an alternate Medicare Advantage Prescription Drug Plan for Imperial Valley seniors.

The Easy Choice Health Plan (HMO) withdrew from the Imperial Valley in late 2014, “creating an immediate crisis for approximately 5,000 seniors,” Wyatt said.

Easy Choice indicated that Molina Healthcare would offer an alternative Medicare Advantage Prescription Drug (MAPD) Plan, however no plan or solution has since been offered.

“The affected seniors are suffering the consequences,” Wyatt said.

The affected citizens are seniors age 65 and above, or those who are permanently disabled, said Wyatt. These residents qualify for Medicare coverage but do not qualify for Medi-Cal, because of a “too high” monthly income.

As a result, these seniors either find their own replacement coverage, anywhere between $250-$450 a month, or pay out-of-pocket for the 20 percent co-pay. All this would have been covered by their prescription drug benefit, Wyatt posited.

“They are in a devastating position,” Wyatt said. The average monthly income from these residents is anywhere between $1,200 to $1,500 a month, he said.

“They either own a home or a car, and (because they do not qualify) stand to lose everything they’ve worked for.”

“They either reduce their food or forgo some of their medication,” he said.

According to Wyatt, Schimer, and Dawson, Molina Healthcare is known to offer MAPD Plans in other areas, but for inexplicable reasons are not offering it here.

Dawson, an advocate for these seniors and Valley native stated, “The Imperial Valley is the only county in the state without this (MAPD) plan.”

District 1 representative, John Renison said, “This is an emergency deal.”

The board passed a unanimous, 4-0 vote to take action in multiple ways. Chairman Ryan Kelley (District 4) was away on board business. Board members will send a letter to Molina, in the hopes of opening up interaction, along with seeking a face-to-face meeting with Molina owners,  brothers, John and Mario Molina. The Board will also utilize health care advocates to assist the Board, and seek the involvement of Imperial County’s Sacramento representatives.

Dawson and Schimer pointed out the irony of the situation, referring to Molina Healthcare’s mission statement: “(To) take care of the poor and needy.”