MANAGED CARE PLAN OFFERED TO MEDICARE BENEFICIARIES IN FAIRFIELD, HARTFORD AND NEW HAVEN COUNTIES IN CONN.
The Centers for Medicare & Medicaid Services (CMS) today approved a request by United Healthcare Insurance Co. Inc. to offer a managed care-preferred provider organization (PPO) plan to Medicare beneficiaries in Fairfield, Hartford and New Haven counties in Connecticut.
United Healthcare Insurance Co., which is based in Hartford and does business as Evercare Choice, will begin serving beneficiaries on July 1 in the three counties. Fairfield County in southern Connecticut is the state’s most populated county, with cities including Bridgeport, Greenwich, Danbury, Stamford and Waterbury. The other two counties include the cities of Hartford and New Haven.
Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage, formerly known as Medicare+Choice. About 406,000 beneficiaries live in the three counties.
"We are pleased that United Healthcare Insurance Co. decided to offer a PPO plan to Medicare beneficiaries in Fairfield, Hartford and New Haven counties in Connecticut,” 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.”
PPO plans are modeled after coverage offered by PPOs to most Americans under age 65. Unlike traditional HMOs, PPOs allow beneficiaries who choose to enroll, access to services provided outside the contracted network of providers.
United Healthcare Insurance is a subsidiary of UnitedHealth Group, based in Minnetonka, Minn. The PPO plan gives beneficiaries in the three counties another health care choice. Two other Medicare Advantage plans, Health Net of Connecticut and Oxford Health Plans, are currently available in the three counties.
“We want to make sure all Medicare beneficiaries, whether in a PPO or another 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."
Medicare Advantage HMOs, PPOs 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 managed care plans. 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.