The Centers for Medicare & Medicaid Services (CMS) has approved a request by Three Rivers Health Plans Inc. to offer managed care coverage to Medicare beneficiaries in Berks County in eastern Pennsylvania .
The plan will begin serving beneficiaries on April 1 in Berks County , including the city of Reading . Medicare beneficiaries can sign up for the plan during the current open enrollment in Medicare Advantage, formerly known as Medicare+Choice. About 64,000 beneficiaries live in Berks County .
"We are pleased Three Rivers Health Plans decided to offer this health plan to beneficiaries in Reading , Pa. , and throughout Berks County ,” HHS Secretary Mike 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.”
The company, a subsidiary of Three Rivers Holdings in Monroesville , Pa. , will give another health care option to beneficiaries in Berks County . The four Medicare Advantage plans currently operating in the county are Aetna Health Inc., AmeriHealth HMO Inc., Keystone Health Plan Central and Sterling Private Fee-for-Service.
"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 45 new contracts with Medicare health plans and 66 service area expansions. There are currently 139 applications pending for new contracts and 32 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.