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UNITED HEALTHCARE INSURANCE CO. TO OFFER MEDICARE MANAGED CARE PLAN IN THREE RHODE ISLAND COUNTIES

The Centers for Medicare and Medicaid Services (CMS) has approved a request by United Healthcare Insurance Co. to offer a new Medicare managed care plan in three Rhode Island counties in the Providence and Warwick areas, as part of a demonstration program recently announced by Health and Human Services Secretary Tommy G. Thompson. The health plans under this program are modeled after coverage offered by preferred provider organizations (PPOs) to most Americans under age 65.

United Healthcare Insurance, based in Minnetonka, Minn., can begin on Feb. 1, 2003, to serve beneficiaries in Kent, Providence and Washington counties with this plan, known as Medicare Complete Choice. Medicare beneficiaries can sign up for the plan during the current open enrollment.

About 150,000 Medicare beneficiaries live in the three counties. These beneficiaries already may also choose between two other Medicare+Choice plans, Coordinated Health Partners and United HealthCare’s existing Medicare Complete HMO plan.

"This demonstration program gives seniors new options for their Medicare coverage similar to that available in the private insurance market," Secretary Thompson said. "Greater access and expanded options and choices in health care are key goals of this Administration."

Congress created Medicare+Choice in the Balanced Budget Act of 1997 to expand the types of health care options available to Medicare beneficiaries, enabling them to receive new preventive benefits and greater patient protections. Preferred provider type coverage was previously unavailable to Medicare beneficiaries.

"Whether beneficiaries enroll in a PPO or another Medicare+Choice plan, or fee-for-service Medicare, we are doing more to guarantee they understand the Medicare options available to them," CMS Administrator Tom Scully said. "The under age 65 market is rapidly flocking toward PPO products, which give patients the flexibility they need. Seniors want the same options and this is the big first step in getting them there."

Currently, Medicare+Choice health maintenance organizations (HMOs) are available where private companies choose to offer them. About 5.6 million Medicare beneficiaries -- out of a total of nearly 40 million aged and disabled Americans -- have enrolled in Medicare HMOs. Original fee-for-service Medicare, available to all beneficiaries, is currently chosen by more than 34 million beneficiaries. Unlike traditional HMOs, the new options will allow beneficiaries who choose to enroll, access to services provided outside the contracted network of providers.

The demonstration program, announced Aug. 27, 2002, includes new health plans that will ultimately be available in 23 states across the country, expanding health care options to approximately 11 million Medicare beneficiaries.

The demonstration plans will be considered Medicare+Choice plans and must offer all of Medicare’s required benefits, but will also have the flexibility to offer additional services, including prescription drugs. Most important, they will offer beneficiaries a wider choice of health care providers than is currently offered in HMOs.

A number of resources with information regarding the plan offered by United Healthcare Insurance are available as part of various CMS consumer information sources, including a national toll-free phone number -- 1-800-MEDICARE (1-800-633-4227), or TTY/TDD, at 877-486-2048, and the CMS Internet site -- www.medicare.gov. In addition, a coalition of more than 200 national and local organizations is available to assist seniors in making informed decisions about their health care options.