October 20 - The Centers for Medicare & Medicaid Services Announces Changes to Provider Networks
[CARSON CITY, NV] — [Date October 20, 2025] — The Nevada Division of Insurance received notice from the Centers for Medicare & Medicaid Services (“CMS”) regarding changes to Kaiser Permanente’s Senior Care Plus program.
CMS states that on December 13, 2026, Kaiser Permanente Nevada (formerly Hometown Health) will have changes to its Medicare Advantage (“MA”) provider network impacting the following contract: H2960. The provider termination pertains to Kaiser Permanente Nevada’s contract with Senior Care Plus, which could impact people living in Carson City, Storey, and Washoe counties.
As a result of this significant change, affected members are eligible for a Special Election Period (“SEP”) with Medigap guaranteed issue (“GI”) rights. Affected members are those enrolled in Kaiser Permanente Nevada’s plans who are assigned to, are currently receiving care from, or have received care within the past three months from a provider or facility being terminated from the Medicare Advantage provider network. The SEP begins the month enrollees are notified by their plan of eligibility for the SEP. The SEP ends two calendar months after the month in which enrollees are notified of their eligibility. This SEP can be used only once per significant change in the provider network.
Insurance Commissioner Ned Gaines contacted CMS and asked them to review the decisions and Special Election Period. “This situation threatened to disrupt access to quality healthcare for many Northern Nevadans, and I applaud Commissioner Gaines and the Division of Insurance for working with the federal government to help protect Medicare beneficiaries and preserve their access to current providers," said Governor Joe Lombardo. "I encourage all affected members to act promptly, review their options during the Special Election Period, and make sure their healthcare coverage continues to meet their needs.”
Consumers should be on the lookout for a notification letter. Medicare Advantage organizations are required to notify affected members of their SEP eligibility with a letter, including information about how to utilize the SEP, their Medigap GI rights, and the length of the SEP. If a member is not affected, then that individual will not be eligible for the SEP and will not receive a letter from the MA organization.
Individuals who use this SEP to elect Original Medicare will have Medigap GI rights under federal law to purchase Medigap plans A, B, C, D, F, and G unless they turn 65 after January 1, 2020, and are prohibited from purchasing plans C and F. Please note that beneficiaries who turned 65 before January 1, 2020, are precluded from purchasing Medigap plans D or G. The GI Rights begin 60 days before the MA plan coverage ends and end 63 days after the MA plan coverage ends. States may have laws that provide more Medigap protections.
Commissioner Gaines urges impacted consumers to take advantage of this opportunity to change plans to ensure they continue to have access to their preferred primary care physician. Commissioner Gaines encourages consumers to engage a trusted producer who is well-versed in Medicare Advantage and Medicare Supplement plans. These plans can be complicated; a trained producer can assist consumers in selecting the plan that best fits their needs and includes the specific providers they want in the plan network.
Impacted consumers can also seek assistance from CMS directly through their Enrollment and Eligibility Mailbox at https://enrollment.lmi.org/DEEPmailbox/mailbox/.
For more information about the Division of Insurance and its services for consumers and industry professionals, visit doi.nv.gov (link: https://doi.nv.gov/).
The mission of the Nevada Division of Insurance is to protect the rights of Nevada consumers in their experiences with the insurance industry and to ensure the financial solvency of insurers. For more information about the Division of Insurance, visit DOI.NV.GOV or follow the Division on X (Twitter), Facebook, LinkedIn, Instagram or YouTube.
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