MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN PART OF NEVADA COUNTY IN CALIFORNIA
The Centers for Medicare & Medicaid Services (CMS) has approved a request by PacifiCare of California Inc. to expand managed care coverage to Medicare beneficiaries in part of Nevada County in Northern California.
PacifiCare of California is now serving beneficiaries1in the western section of Nevada County. The plan covers nine ZIP codes in that part of the county. Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage, formerly known as Medicare+Choice. About 18,000 beneficiaries live in the plan’s newly approved service area.
"We are pleased PacifiCare of California decided to expand this health plan to include more Medicare beneficiaries in Northern California,” 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 company, which began serving Medicare beneficiaries in 1985 in Los Angeles and Orange counties, now serves 20 counties throughout Northern and Southern California, including the cities of Los Angeles, Oakland, Riverside and San Diego.
PacifiCare of California is a subsidiary of PacifiCare Health Systems, based in Cypress, Calif. The plan gives another health care choice to some beneficiaries in Nevada County. No other Medicare Advantage plans currently operate in the 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, when President Bush signed the Medicare Modernization Act into law, CMS has approved 10 new contracts with Medicare health plans and 32 service area expansions. There are currently 29 applications pending for new contracts and 21 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.