The Centers for Medicare & Medicaid Services (CMS) has approved a request by Blue Cross of California to offer private fee-for-service health care coverage to Medicare beneficiaries in Tulare County in Central California .
Blue Cross of California will begin on May 1 serving beneficiaries through its private fee-for-service plan in Tulare County , including the cities of Visalia and Porterville . About 46,000 beneficiaries live in the county. Beneficiaries can sign up for the plan during the current open enrollment in Medicare Advantage, formerly known as Medicare+Choice.
“We are pleased Blue Cross of California has decided to offer this health plan to serve Tulare 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.”
Blue Cross of California has a private fee-for-service plan in Fresno , San Francisco , Santa Barbara and Yolo counties in California .
The company, a subsidiary of WellPoint Health Networks Inc. based in Thousand Oaks , Calif. , currently offers the private fee-for-service plan under the Medicare Advantage program. The plan will give another health care option to beneficiaries in Tulare County . Kaiser Permanente currently operates the only Medicare Advantage plan in that 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," 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."
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.
Since Dec. 8, 2003, when President Bush signed the Medicare Modernization Act into law, CMS has approved 53 new contracts with Medicare health plans and 73 service area expansions. There are currently 212 applications pending for new contracts and 107 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.