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MEDICARE MANAGED CARE PLAN OFFERED IN 12 LOUISIANA PARISHES INCLUDING CITIES OF NEW ORLEANS, BATON ROUGE

MEDICARE MANAGED CARE PLAN OFFERED IN 12 LOUISIANA PARISHES INCLUDING CITIES OF NEW ORLEANS, BATON ROUGE

The Centers for Medicare & Medicaid Services (CMS) has approved a request by Humana Health Benefit Plan of Louisiana Inc. to offer managed care coverage to Medicare beneficiaries in 12 parishes in Louisiana  including the cities of New Orleans and Baton Rouge .

Humana Health Benefit Plan of Louisiana, a preferred provider organization (PPO) based in Metarie, La., will begin on Jan. 1 serving beneficiaries in these 12 parishes – Ascension, East Baton Rouge, Iberville, Jefferson, Livingston, Orleans, Plaquemines, St. Bernard, St. Charles, St. Tammany, Washington and West Baton Rouge. Medicare beneficiaries can sign up for the plan during the current open enrollment in Medicare Advantage, formerly known as Medicare+Choice. About 270,000 beneficiaries live in the 12 counties.  

"We are pleased Humana Health Benefit Plan of Louisiana decided to offer this health plan to beneficiaries in 12 Louisiana parishes,” 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.”

Humana Health Benefit Plan of Louisiana, a subsidiary of Humana Inc. based in Louisville  , Ky. , already offers an HMO health care option to beneficiaries in these 12 parishes. The new plan will give another health care option to beneficiaries in the 12 parishes.  Other Medicare Advantage plans currently operating in at least one parish are Corsolutions New Plan, Sterling Life Insurance Co., Health Care Select PPO and Tenet Choice 65.

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.

"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 37 new contracts with Medicare health plans and 51 service area expansions.   There are currently 23 applications pending for new contracts and 26 service area expansions pending.

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 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.