MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN TWO TEXAS COUNTIES
The Centers for Medicare & Medicaid Services (CMS) today approved a request by Texas HealthSpring Inc. to expand managed care coverage to Medicare beneficiaries in two counties in southern Texas.
Texas HealthSpring, based in Houston, Texas, can now sign up beneficiaries throughout Orange County and most of Galveston County, except for Galveston Island, Texas (see attachment for ZIP codes included in the plan). The company can begin serving beneficiaries on Jan. 1, 2004. Medicare beneficiaries can sign up for the plan during the current Medicare+Choice open enrollment. About 35,000 beneficiaries live in the managed care organization's newly approved service area.
"We are pleased Texas HealthSpring decided to expand this health plan to include more Medicare beneficiaries in southern Texas," 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."
Texas HealthSpring, which took over the Medicare HMO contract of AmCare Health Plan of Texas Inc. last year, began serving beneficiaries on Nov. 1, 2002, in the Texas counties of Jefferson and Harris, including the city of Houston, and on Jan. 1, 2003, beneficiaries in Fort Bend County. The plan, which will operate as Texas HealthSpring Medicare+Choice Plan, will give another health care choice to beneficiaries in Orange counties and part of Galveston County. These beneficiaries currently are served by SelectCare of Texas L.L.C.
"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.
The following ZIP codes in Galveston County are included in the expansion of Texas HealthSpring's Medicare managed care plan:
77510, 77517, 77518, 77539, 77546, 77549, 77563, 77565, 77568, 77573, 77574, 77590, 77591, 77592.