The Centers for Medicare & Medicaid Services (CMS) has approved a request by HealthSpring of Alabama Inc. to expand managed care coverage to Medicare beneficiaries in six counties in central and southwestern Alabama.
HealthSpring of Alabama, based in Birmingham, Ala., can begin serving beneficiaries in the six counties on Jan. 1, 2004. Medicare beneficiaries can sign up for the plan during the current Medicare+Choice open enrollment. About 68,000 beneficiaries live in the counties of Bibb, Blount, Chilton, St. Clair and Walker in the Birmingham area in central Alabama, and in Baldwin County in the Mobile area in southwestern Alabama.
HealthSpring of Alabama began serving beneficiaries in Alabama in 1994. The company currently operates a Medicare+Choice plan in Jefferson, Shelby and Mobile counties, including the cities of Birmingham and Mobile.
"We are pleased HealthSpring of Alabama decided to expand this health plan to include more Medicare beneficiaries in the Birmingham and Mobile areas," HHS Secretary Tommy G. Thompson said. "The reality is, Medicare should provide all seniors - no matter where they live - with better health insurance options, including prescription drug coverage and preventive care. The President's goals for strengthening and modernizing Medicare will move us closer to that goal."
HealthSpring of Alabama is a subsidiary of NewQuest Health Solutions Inc., based in Nashville, Tenn. The company’s product, Seniors First, gives beneficiaries in five of the six counties at least one other Medicare+Choice organization to select. UnitedHealthCare of Alabama currently operates in Bibb, Blount, Chilton, St. Clair and Walker counties. Viva Health-Alabama operates only in Blount and St. Clair counties. Baldwin County does not currently have a Medicare+Choice plan.
"We want to make sure all Medicare beneficiaries, whether in a Medicare+Choice plan or fee-for-service, are receiving the highest quality health care," CMS Administrator Tom Scully 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+Choice 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.
Congress created Medicare+Choice in the Balanced Budget Act of 1997 to expand the types of health care options available to Medicare beneficiaries, who in addition can now receive new preventive benefits and patient protections. There also is 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.