Press Releases

Details for: MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN CLEVELAND AND 3 OHIO COUNTIES

The Centers for Medicare & Medicaid Services (CMS) has approved a request by SummaCare Inc. to expand managed care coverage to Medicare beneficiaries in Cuyahoga   County including the city of Cleveland and two other northeastern Ohio counties.

SummaCare, based in Akron , Ohio , is now serving beneficiaries in Cuyahoga County in the Cleveland metro area and rural Carroll and Wayne counties.    Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage plans. About 255,000 beneficiaries live in the three counties.

"We are pleased SummaCare decided to expand this health plan to include Medicare beneficiaries in the Cleveland area and in Carroll and Wayne counties,” HHS Secretary Mike Leavitt 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.”

SummaCare is an HMO that has served Medicare beneficiaries for nearly a decade in Ohio . It currently also operates in Medina , Portage , Stark and Summit counties.

The plan gives another health care choice to beneficiaries in Carroll, Cuyahoga and Wayne counties. A Medicare Advantage plan currently operating in Cuyahoga and Wayne counties is Community Insurance Co., an HMO also known as Anthem Insurance.   McKinley Life Insurance Co. operates in Carroll and Wayne counties. The Medicare Advantage plans currently operating only in Cuyahoga County include Humana Inc., QualChoice Health Plan HMO and United HealthCare of Ohio. Hometown Health Plan HMO is only in Wayne County .

“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 71 new contracts with Medicare health plans and 97 service area expansions.  There are currently 218 applications pending for new contracts and 85 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.