MEDICARE MANAGED CARE PLAN EXPANDS TO INCLUDE BENEFICIARIES THROUGHOUT PUERTO RICO
The Centers for Medicare & Medicaid Services (CMS) has approved a request by MMM Healthcare Inc. to expand managed care coverage to Medicare beneficiaries in 19 Puerto Rican municipalities. As a result, the company's plan now covers beneficiaries throughout Puerto Rico.
MMM Healthcare, based in San Juan, Puerto Rico, is now serving beneficiaries in the 19 municipalities. The newly approved service area includes about 115,000 Medicare beneficiaries in the island's western region. Beneficiaries can sign up for the plan during the current Medicare+Choice open enrollment.
The plan will expand into the municipalities of Aguada, Aguadilla, Anasco, Cabo Rojo, Camuy, Hatillo, Hormigueros, Isabela, Lajas, Lares, Las Marias, Maricao, Mayaguez, Moca, Quebradillas, Rincon, Sabana Grande, San German and San Sebastian.
"We are pleased MMM Healthcare decided to expand this health plan to include 19 more municipalities so it now covers the entire island of Puerto Rico," 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 plan began serving beneficiaries in September 2001, in 19 municipalities including Arecibo, Manati and Ponce. The plan expanded in December 2001, to include 14 more municipalities, including San Juan, and in October 2002, to include 26 other municipalities, mostly on the eastern part of the island.
"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."
MMM Healthcare, the only Medicare+Choice plan in Puerto Rico, operates as Medicare y Mucho Mas (Medicare and Much More).
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.