The Centers for Medicare & Medicaid Services (CMS) has approved a request by UniCare Life and Health Insurance Co. to expand its private fee-for-service health care coverage to more Medicare beneficiaries in Michigan, North Carolina and Utah.
The company, based in Newbury Park, Calif., is now serving beneficiaries in 54 additional counties in the three states – 35 in North Carolina, 13 in Utah and 6 in Michigan. The plan expansion includes the Ogden, Salt Lake City, Utah area; the Holland-Grand Rapids, Mich. area; and the Asheville, Durham, Greensboro and Winston-Salem, N.C., areas. The plan is now serving beneficiaries in a majority of the counties in those states. (A list of the counties in each state is attached).
Beneficiaries can sign up for the plan during the current open enrollment in Medicare Advantage, formerly known as Medicare+Choice. About 585,000 beneficiaries live in the newly approved service area.
“We are pleased UniCare decided to expand this health plan to include more beneficiaries in Michigan, North Carolina and Utah," 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.”
UniCare began serving beneficiaries in the Midwest and South in 2003. The company currently operates a private fee-for-service, Medicare Advantage plan in 11 states, mostly in the Midwest. About 2.3 million beneficiaries live in the 348 counties that UniCare serves. The other eight states are Illinois, Indiana, Iowa, Kentucky, Minnesota, Nebraska, Virginia and Wisconsin.
A private fee-for-service plan is an insurance program that charges enrollees a premium and cost-sharing amounts and lets beneficiaries choose the providers they want to see, as long as these providers accept the private fee-for-service insurance program.
UniCare is a subsidiary of WellPoint Health Networks Inc., based in Thousand Oaks, Calif. The company’s product, Security Choice, gives beneficiaries in the 11 states another Medicare Advantage organization to select. Several Medicare Advantage plans currently operate in the newly approved service area.
"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, when President Bush signed the Medicare Modernization Act into law, CMS has approved 10 contracts with Medicare health plans and 33 service area expansions. There are currently 32 applications pending for new contracts and 19 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.