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MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN MEMPHIS AND THREE TENN. COUNTIES
MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN MEMPHIS AND THREE TENN. COUNTIES
The Centers for Medicare & Medicaid Services (CMS) has approved a request by HealthSpring Inc. to expand managed care coverage to Medicare beneficiaries in three southwestern Tennessee counties including the city of Memphis.
HealthSpring, based in Nashville, Tenn., will begin serving beneficiaries on Jan.1 in the counties of Fayette, Shelby including Memphis, and Tipton. Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage, formerly known as Medicare+Choice. About 152,000 beneficiaries live in the three counties.
"We are pleased HealthSpring decided to expand this health plan to include more Medicare beneficiaries in Tennessee,” 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.”
HealthSpring began serving Medicare beneficiaries in 1997 in the Tennessee counties of Cannon, Cheatham, Davidson, Dekalb, Macon, Marshall, Robertson, Rutherford, Smith, Sumner, Trousdale, Williamson and Wilson.
The plan gives another health care choice to beneficiaries in the Memphis area. The other Medicare Advantage plans currently operating in Fayette, Shelby and Tipton counties are Humana Private Fee for Service (PFFS) and Sterling PFFS.
“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," said CMS Administrator Mark McClellan, M.D., Ph.D. "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."
Since Dec. 8, when President Bush signed the Medicare Modernization Act into law, CMS has approved 15 new contracts with Medicare health plans and 42 service area expansions. There are currently 40 applications pending for new contracts and 16 service area expansions pending.
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.