MANAGED CARE PLAN OFFERED TO MEDICARE BENEFICIARIES IN SAN JUAN AND 50 OTHER MUNICIPALITIES IN PUERTO RICO
The Centers for Medicare & Medicaid Services (CMS) has approved a request by MCS Life Insurance Co. to offer managed care coverage to Medicare beneficiaries in the San Juan , Puerto Rico metro area and 50 other municipalities in Puerto Rico .
MCS Life Insurance, based in San Juan , can begin on Jan. 1 serving beneficiaries in San Juan and 50 other northern and western municipalities. Medicare beneficiaries can sign up for the plan during the current open enrollment in Medicare Advantage, formerly known as Medicare+Choice.
About 325,000 beneficiaries live in the managed care organization’s newly approved service area, which ranges from the northeastern part of Puerto Rico to Cabo Rojo and San German municipalities on the island’s western section.
"We are pleased MCS Life Insurance Co. decided to offer this health plan to many beneficiaries in Puerto Rico ,” 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.”
MCS Life Insurance, doing business as MCS Classicare Plan, will give another health care option to beneficiaries in the 51 municipalities. Two other Medicare Advantage plans currently operate in Puerto Rico .
"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 15 new contracts with Medicare health plans and 42 service area expansions. There are currently 40 applications pending for new contracts and 16 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.