MEDICARE PLAN OFFERED TO BENEFICIARIES IN IOWA, NEBRASKA, SOUTH DAKOTA, WISCONSIN
The Centers for Medicare & Medicaid Services (CMS) has approved a request by United Healthcare Insurance Co. to offer private fee-for-service health care coverage to Medicare beneficiaries in Iowa, Nebraska, South Dakota and Wisconsin.
United Healthcare Insurance Co. is now serving beneficiaries throughout the four states. About 509,000 beneficiaries live in the states. Beneficiaries can sign up for the plan during the current open enrollment in Medicare Advantage, formerly known as Medicare+Choice.
“We are pleased United Healthcare Insurance Co. has decided to serve beneficiaries in the four midwestern states,” 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.”
The company, a subsidiary of United Health Group based in Minnetonka, Minn., is offering the private fee-for-service plan under the Medicare Advantage program.
The plan will give another health care option to beneficiaries in the four states. Nebraska has one Medicare Advantage plan, Sterling Life Insurance Co., currently operating. Iowa and South Dakota have plans by Sterling Private Fee for Service and Humana. Iowa also has John Deere Health Plan and Medical Associates Health Plan. In Wisconsin, the current choices are Network Health Plan of Wisconsin, Medical Associates Clinic Health Plan, Security Health Plan of Wisconsin and Gundersen Lutheran Health Plan.
United Healthcare Insurance offers another Medicare Advantage product, known as Medicare Complete, in parts of Iowa, Nebraska and Wisconsin.
A private fee-for-service plan is an insurance program that charges enrollees a premium and cost-sharing amounts and lets beneficiaries choose the providers they want to see, as long as these providers accept the private fee-for-service insurance program.
"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," CMS Administrator Mark McClellan, Ph.D., M.D., said. "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 10 new contracts with Medicare health plans and 27 service area expansions. There are currently 28 applications pending for new contracts and 22 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.