MANAGED CARE PLAN EXPANDS TO INCLUDE MEDICARE BENEFICIARIES IN SEVEN COUNTIES IN SOUTHEASTERN TEXAS
The Centers for Medicare & Medicaid Services (CMS) has approved a request by Texas HealthSpring LLC to expand managed care coverage to Medicare beneficiaries throughout six counties, and part of a seventh county, in southeastern Texas.
Texas HealthSpring is now serving beneficiaries in all of Brazoria, Hardin, Polk, San Jacinto, Walker and Waller counties and northeastern Galveston County (ZIP code 77511). Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage, formerly known as Medicare+Choice. About 62,000 beneficiaries live in the newly approved service area.
"We are pleased Texas HealthSpring decided to expand this health plan to include more Medicare beneficiaries in southeastern Texas,” 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.”
Texas HealthSpring, based in Houston, Texas, began serving beneficiaries in 2002 in Jefferson and Harris counties, including the city of Houston, and in 2003 in Fort Bend County. Earlier this year, the plan added beneficiaries in Chambers, Liberty, Montgomery, and Orange counties and most of Galveston County, except for Galveston Island.
The plan, which operates as Texas HealthSpring, will give another health care choice to beneficiaries in the service area expansion. The only Medicare Advantage plan currently operating in these counties is SelectCare of Texas in Hardin County and part of Brazoria 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 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.