MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN THREE SUBURBAN PHILADELPHIA COUNTIES
The Centers for Medicare & Medicaid Services (CMS) has approved a request by Elder Health Pennsylvania HMO to expand its managed care plan to Medicare beneficiaries in three suburban Philadelphia, Pa., counties.
Elder Health Pennsylvania HMO, based in Philadelphia, can now sign up beneficiaries in the suburban counties of Bucks, Delaware and Montgomery, including the cities of Norristown and Pottstown, and can begin serving them on Jan. 1, 2004. About 309,000 beneficiaries live in the three counties. Beneficiaries can sign up for the plan during the current Medicare+Choice open enrollment.
"We are pleased Elder Health Pennsylvania HMO has decided to expand this health plan to more Medicare beneficiaries in the Philadelphia area," 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."
The company began serving beneficiaries in the city of Philadelphia in January 2002. The plan, which operates as MediChoice Pensylvania, will give another health care choice to beneficiaries in the three counties. These beneficiaries already can choose among four Medicare+Choice plans – Aetna Health Inc., Independence Blue Cross, Keystone Health Plan East, and Sterling PFFS. A fifth plan, UnitedHealthCarePPO, is available only to beneficiaries in Montgomery County.
"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.
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.