Changes Coming For Some Excellus Customers

Oct 9, 2013

There's a change coming for some Excellus Blue Cross Blue Shield customers. 

The insurance organization says that in 2014, it will end its participation in Medicaid Managed Care and Family Health Plus programs in 25 counties including the Rochester area.

That will affect about 200,000 people in New York State, early next year.

Excellus spokesman Jim Redmond says the reason is that the company is seeing losses approaching $100 million for this year on Medicaid Managed Care and Family Health Plus, and that amount could increase next year. Redmond says losses of that size are just not sustainable.

The statement from Excellus said in part that,” We have a long history of supporting safety net programs but we cannot continue to do so while incurring such large financial losses. We have had several meetings with the State throughout 2013 to see if the losses could be addressed by changes in reimbursements that the State pays us to provide coverage. We value the State as a partner but we have been informed that changes that would meaningfully reduce these losses are not forthcoming.”

Excellus will still provide Child Health Plus in the affected counties. The announcement does not affect any of its Medicare plans. The Medicaid beneficiaries would still have health insurance, and Excellus is working with the state on a transition plan for those who are affected.