MANAGED CARE PLAN EXPANDS TO INCLUDE MORE MEDICARE BENEFICIARIES IN ALAMEDA, CONTRA COSTA COUNTIES, CALIF.
The Centers for Medicare & Medicaid Services (CMS) has approved a request by PacifiCare of California Inc. to expand managed care coverage to Medicare beneficiaries throughout Alameda and Contra Costa counties in the San Francisco Bay Area in Northern California.
PacifiCare of California, based in Cypress, Calif., will begin serving beneficiaries on March 1 in eastern Alameda County, including the cities of Dublin, Fremont, Newark and Union City, and northern and eastern Contra Costa County, including the cities of Antioch, Livermore, Martinez, Danville and Walnut Creek. The company then will serve all of both counties.
Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage, formerly known as Medicare+Choice. Currently, the company offers Medicare Advantage plans in parts of Alameda and Contra Costa counties. About 300,000 beneficiaries live in the two counties.
"We are pleased PacifiCare of California decided to expand this health plan to include more Medicare beneficiaries in the two Bay Area counties,” HHS Secretary Michael Leavitt 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 is a subsidiary of PacifiCare Health Systems, based in Cypress, Calif., which began serving Medicare beneficiaries in 1985 in Los Angeles and Orange counties in Southern California. The plan now covers 23 counties in Northern and Southern California including the cities of Los Angeles, San Francisco, Sacramento and San Diego.
The plan will give another health care choice to beneficiaries in Alameda and Contra Costa counties. The other Medicare Advantage plans currently operating in the two counties are Health Net, Kaiser and Contra Costa Health.
“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 57 service area expansions. There are currently 35 applications pending for new contracts and 30 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.