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Tuesday, November 05, 2002

By Pamela Gaynor, Post-Gazette Staff Writer

UPMC Health System has notified Allegheny County customers of its UPMC for Life Medicare HMO that their monthly premiums will increase sharply beginning in January.

Members in the HMO's Standard plan will see premiums surge nearly fivefold, from $9 to $44. Premiums for UPMC for Life's Deluxe plan will jump 84 percent, from $58 to $107.

The only difference between the plans is that the Standard version carries no prescription benefits while the Deluxe version offers $350 worth of coverage during each quarter of the year.

UPMC for Life began business in the county in March and has since enrolled 2,885 members here. Memberships in outlying counties, where premiums differ, have been offered since the beginning of 2001.

UPMC spokesman William Sawchak defended the increases, saying they were "in line with what the competition is doing."

"Certainly the prices reflect what our [claims] experience has been. The pricing certainly doesn't reflect any kind of huge profit margin," he said.

The Oakland-based health plan is the latest of three Medicare HMO operators in the county to announce rates for the coming year.

The biggest, Highmark Inc.'s Security Blue Medicare HMO, which offers four plans, also announced sharp increases in Allegheny County and surrounding counties. For example, it plans to triple monthly premiums for Allegheny County members of its Basic plan, which affords no prescription drug coverage, to $36. Highmark said the increases reflected rising medical costs.

The county's second largest Medicare HMO insurer, Health America, however, said it didn't plan to raise the $35 monthly premium for Allegheny County customers of its Advantra Medicare HMO, though it does plan 2002 premium increases in some outlying counties.