Press Releases

MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN TWO COUNTIES IN SOUTHERN TEXAS

The Centers for Medicare & Medicaid Services (CMS) has approved a request by PacifiCare of Texas Inc. to expand managed care coverage to Medicare beneficiaries in two counties in Southern Texas.    

PacifiCare of Texas, based in San Antonio  , Texas , will begin serving beneficiaries on June 1 in Atascosa   and Kendall counties. Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage plans. About 20,000 beneficiaries live in the two counties.

"We are pleased PacifiCare of Texas decided to expand this health plan to Medicare beneficiaries in Southern Texas ,” HHS Secretary Mike Leavitt 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.”

PacifiCare of Texas, which does business as Secure Horizons, is a subsidiary of PacifiCare Health Systems, based in Cypress  , Calif. The plan began serving Medicare beneficiaries in 1985 in Los Angeles and Orange counties in Southern California and now covers 23 counties in Northern and Southern California including the cities of Los Angeles , Fresno , San Francisco , Sacramento and San Diego .  

The plan will give another health care choice to beneficiaries in Atascosa and Kendall counties. The only Medicare Advantage plan currently operating in these counties is Humana Preferred Provider Organization in Kendall  County .  

“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, 2003, when President Bush signed the Medicare Modernization Act into law, CMS has approved 68 new contracts with Medicare health plans and 91 service area expansions.  There are currently 210 applications pending for new contracts and 91 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