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MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN 3 N.J. COUNTIES

MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN 3 N.J. COUNTIES

The Centers for Medicare & Medicaid Services (CMS) has approved a request by Aetna to expand managed care coverage to Medicare beneficiaries in three New Jersey counties.

Aetna, based in Hartford , Conn. , will begin serving beneficiaries on Jan.1 in Burlington and Gloucester counties in southern New Jersey , and Morris County in northern New Jersey . Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage, formerly known as Medicare+Choice.  About 164,000 beneficiaries live in the three counties.

"We are pleased Aetna decided to expand this health plan to include more Medicare beneficiaries in New Jersey ,” 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.”

Aetna began serving Medicare beneficiaries in New Jersey in 1993 as a Medicare HMO.  Its current service area includes 11 New Jersey counties, mostly in the northern part of the state, and includes the cities of Jersey City and Newark .

The plan gives another health care choice to beneficiaries in the three counties. The other Medicare Advantage plan currently operating in these counties is Horizon Healthcare Inc.

“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 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.