Press Releases
MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN SAN FRANCISCO AND PARTS OF 2 COUNTIES
MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN SAN FRANCISCO AND PARTS OF 2 COUNTIES
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 San Francisco, Calif., and two northern California counties.
PacifiCare of California, based in Cypress, Calif., will begin serving beneficiaries on Jan.1 in San Francisco County, including the city of San Francisco. In the San Francisco Bay Area, most of Sonoma County is included and in central San Mateo County, the plan’s existing coverage area will be extended.
Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage, formerly known as Medicare+Choice. About 287,000 beneficiaries live in the three counties.
The company began serving Medicare beneficiaries in 1985 in Southern California in Los Angeles and Orange counties and now serves 20 counties in Northern and Southern California, including the cities of Sacramento and San Diego.
"We are pleased PacifiCare of California decided to expand this health plan to include more Medicare beneficiaries in the San Francisco Bay 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.”
PacifiCare of California, a subsidiary of Pacific Health Systems, gives another health care choice to beneficiaries in the Bay Area. The other Medicare Advantage plans currently operating in the newly approved service area include Kaiser in all three counties, and Health Net in San Francisco and San Mateo counties.
“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 12 new contracts with Medicare health plans and 38 service area expansions. There are currently 40 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.