A second HMO is planning to provide a health care plan to senior citizens in northern Gila County.
Premier Healthcare of Arizona plans to start signing up members in the Payson area Monday, according to Adam Gutierrez, director of Medicare marketing for the company.
The competition with the current HMO serving senior citizens in the area, Intergroup Seniorcare -- and with it, lower copayments -- has long been something local seniors have sought.
Premier members will have to continue to pay their Medicare premiums, but the HMO offers additional benefits not otherwise covered by Medicare, said Gutierrez.
Joy Hall, customer representative with Premier, said the company offers a better prescription coverage than some of the other HMOs.
"With us, our prescription coverage seems to be a little higher than with other plans," she said. "We offer a maximum coverage of $2,000 per year."
Hall said Premier members pay $4 for each generic prescription and $15 for brand name prescriptions. For in-patient and out-patient care at a hospital, members have no copayments with the exception of emergency visits, which are $25.
Norma Gilchrist, Premier's local representative, said a number of meetings have been scheduled in the area for next week for those who are interested in becoming members of Premier for Seniors.
Premier has contracted for coverage with local doctors.
Dr. Ray Hatch, a long-time physician in the area and medical director of Central Arizona Independent Providers Association -- an organization of local physicians -- said every doctor in the area has signed on with the company with the exception of Arizona First doctors.
Hatch said the Central Arizona IPA is in the process of credentialing other medical care providers.
"We are also connecting with doctors in the Lutheran (hospital) network," he said. "The Central Arizona IPA is not a closed organization. We are open to anyone who wants to belong."
No contract with hospital
While local doctors are signing on with Premier, Payson Regional Medical Center officials say they currently have no contract with the HMO. Until that happens, Premier patients will have to use hospitals in the Valley for certain kinds of care.
"We're still in negotiations with Premier -- that's all I can say at this point," said Missy Spencer, PRMC's assistant CEO.
Sandra Dina, regional vice president for Physician Health Corp., the managing entity for Central Arizona IPA, said the group of doctors is continuing to work with PRMC in an effort to get them to sign a contract with Premier.
"We're patient advocates," she said. "We're trying to provide affordable care at the hospital here."
Until PRMC finalizes its contract with Premier, those who sign up with the area's new HMO will receive their routine care for normal hospital needs from Mesa Lutheran Hospital and Valley Lutheran Hospital, both of Mesa. They are the closest hospitals outside Payson.
"Emergencies can be handled anywhere, including PRMC," Gutierrez said. "If the patient is stabilized and they're OK, post-emergency hospital care would be handled in the Mesa Lutheran hospitals."
HMO in works for a year
Hatch said the Central Arizona IPA has been trying for a year to provide a second HMO in the area.
"Most doctors and patients are frustrated with the only senior care product here now," he said.
In a statement issued Wednesday, Gutierrez said Premier has experienced record-breaking enrollment for its senior health care plan and has gone out to rural communities throughout the state.
The HMO has 12,000 members in Arizona and a growing network of local doctors and hospitals.
Officials with Premier met with two independent practice associations in the Payson area earlier this year after being approved by a Washington, D.C. health care financing group.
Another HMO, Cigna, decided against coming to the Payson area, leaving only one HMO, Intergroup, to serve the area.
Low payments from Medicare to HMOs in rural communities prevent competition from coming into many of these areas, Gutierrez said. The payments from Medicare to the HMOs vary from state to state and county to county, reflecting the costs of medical services in the different areas.
Premier Healthcare Meetings
Premier Healthcare of Arizona has scheduled a series of meetings next week to explain its program.
Meetings about Premier Healthcare's Senior Plan with local representative Norma Gilchrist are scheduled as follows:
- Monday, Dec. 7 at Mario's Restaurant at 8:30 a.m., 11 a.m., 1:30 p.m. and 3 p.m.
- Tuesday, Dec. 8 at the Elks' Lodge at 10 a.m., 1:30 p.m. and 3 p.m.
- Wednesday, Dec. 9 at the Elk's Lodge at 10 a.m., 1:30 p.m. and 3 p.m.
- Thursday, Dec. 10 at the Elks' Lodge at 10 a.m., 1:30 p.m. and 3 p.m.
- Friday, Dec. 11 at Mario's Restaurant at 8:30 a.m., 11 a.m., 1:30 p.m. and 3 p.m.
Seating may be limited. Interested persons can call 1-800-897-9936 for reservations.