Montcalm County’s Health Care Plus ‘doing just fine’

By Elisabeth Waldon • Last Updated 11:41 am on Tuesday, December 20, 2011

STANTON — Health Care Plus is not losing money as Montcalm County officials previously thought.

Emergency Medical Services (EMS) Director David Feldpausch previously told the Board of Commissioners he was predicting Health Care Plus would lose $5,000 or more this year due to a combination of more claims and greater claim amounts. The plan was thought to have been losing money since 2008 and commissioners were in the process of seeking legal advice.

But Felpausch recently discovered that the program had funds unknown to him.

“We discovered that a portion of subscription fees were being deposited into an account that should have been rolled over in to the budget for the following year and they were not being rolled over,” Feldpausch said. “We had quite a bit of money that we didn’t realize we had. Health Care Plus is not having money problems, in fact it’s doing just fine.”

EMS began offering Health Care Plus in 1997. The goal was to give people on a fixed income or Medicare a copay option for ambulance transportation costs.

The standard Medicare copay is 20 percent. Health Care Plus covers all out-of-pocket expenses for “medically necessary” transportation provided by EMS for subscribers, their spouses and dependent children living in the same household.
Anyone is eligible to subscribe to the program, but EMS has focused its marketing efforts on low-income residents.

Although the program is doing well financially, Feldpausch still wants to make some changes, including price increases to help keep the program financial stable. Commissioners are reviewing his proposed changes.

“The program is still vulnerable if we receive a large number of claims from underinsured or uninsured participants,” Feldpausch said. “The entire program operates on a budget of around $10,000 so it does not take many large claims to significantly change the financial stability of the program.”

Health Care Plus currently has 327 participants. Last fiscal year, 83 claims were made, eight of which were more than $200.

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