MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN BALTIMORE AND 5 SUBURBAN COUNTIES
The Centers for Medicare & Medicaid Services (CMS) has approved a request by Aetna to expand managed care coverage to Medicare beneficiaries in Baltimore City and County, Md. , and five suburban Baltimore counties.
Aetna, based in Hartford, Conn. , will begin on Feb. 1 serving beneficiaries in Baltimore City and County and Anne Arundel, Calvert, Charles, Harford and Howard counties outside Baltimore. Under this plan, the company will serve beneficiaries in a traditional Medicare HMO that it will offer along with its currently operating HMO with a point-of-service option. The service area for both plans is Baltimore City and County and the five suburban counties.
Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage, formerly known as Medicare+Choice. About 349,000 beneficiaries live in the newly approved service area.
Aetna began serving beneficiaries in 2001 in Maryland as a preferred provider organization (PPO) demonstration project.
"We are pleased Aetna decided to offer another plan to serve beneficiaries in the Baltimore area,” 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.”
The plan gives another health care choice to beneficiaries in Aetna’s service area. The other Medicare Advantage plans currently operating in this area are ElderHealth Maryland HMO and Kaiser Permanente.
“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 41 new contracts with Medicare health plans and 56 service area expansions. There are currently 32 applications pending for new contracts and 24 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.