MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN FOUR WESTERN ILLINOIS COUNTIES
The Centers for Medicare & Medicaid Services (CMS) today approved a request by Humana Insurance Co. to expand private fee-for-service health care coverage to Medicare beneficiaries in four counties in western Illinois.
Humana Insurance Co., based in Louisville, Ky., will begin on June1 serving beneficiaries in Henry, Mercer, Rock Island and Whiteside counties, including the cities of Moline and Rock Island. Beneficiaries can sign up for the plan during the current open enrollment in Medicare Advantage, formerly known as Medicare+Choice. About 50,100 beneficiaries live in the four counties.
“We are pleased Humana Insurance Co. has decided to serve beneficiaries in western Illinois," HHS Secretary Tommy G. Thompson said. "Under the Medicare reform law signed by President Bush, Medicare will provide all seniors - no matter where they live - with better health insurance options, including prescription drug coverage and preventive care. The law is achieving the President's goals of strengthening and modernizing Medicare.”
Humana Insurance Co., a subsidiary of Humana Inc., based in Louisville, is offering the private fee-for-service plan under the Medicare Advantage program. The plan, which operates as Humana Gold Choice, began serving Medicare beneficiaries in Illinois in 2001. It will give beneficiaries in the four new counties another health care option to select. Plans currently operating in one or more of the counties are Unicare Life and Health, Sterling Life Insurance and John Deere Health Plan.
A private fee-for-service plan is an insurance program that charges enrollees a premium and cost-sharing amounts and lets beneficiaries choose the providers they want to see, as long as these providers accept the private fee-for-service insurance program.
"We want to make sure all Medicare beneficiaries, whether in a Medicare Advantage plan or fee-for-service, are receiving the highest quality health care," CMS Administrator Mark McClellan, Ph.D., M.D., said. "We are doing more to guarantee that beneficiaries understand the Medicare coverage options available to them. We also are reminding beneficiaries of the need to work closely with the doctors and other health care providers that give them medical care."
Medicare Advantage HMOs and fee-for-service plans are available where private companies choose to offer them. Currently, about 4.6 million Medicare beneficiaries -- out of a total of about 40 million aged and disabled Americans – have enrolled in Medicare HMOs. Original fee-for-service Medicare, currently chosen by more than 35 million beneficiaries, is available to all beneficiaries.
Medicare has a far-reaching consumer information program that includes a national toll-free phone number -- 1-800-MEDICARE (1-800-633-4227) or TTY/TDD, at 877-486-2048 -- an Internet site -- www.medicare.gov -- and a coalition of more than 200 national and local organizations to provide seniors more information.