Medicare News

The Centers for Medicare and Medicaid Services (CMS) today approved a request by Humana Health Plan Inc. to expand its managed care plan to Medicare beneficiaries on the Far North Side of Chicago, Ill.

Humana Health Plan, based in Chicago, can begin on Jan. 1, 2003, to serve beneficiaries on the Far North Side including Lincolnwood. Medicare beneficiaries can sign up for the plan during open enrollment, which runs through Dec. 31. About 1,400 Medicare beneficiaries live in the managed care organization's newly approved service area, which includes these four ZIP codes: 60626, 60645, 60659 and 60660.

The plan, which began operations in 1985, currently serves beneficiaries in Kendall County, Ill., and parts of Cook and Kane counties in Illinois.

"We are pleased that Humana Health Plan decided to expand this health plan to include more Medicare beneficiaries on Chicago’s Far North Side," HHS Secretary Tommy G. Thompson said. "The reality is, Medicare should provide all seniors - no matter where they live - with better health insurance options, including prescription drug coverage and preventive care. The President's principles for strengthening and modernizing Medicare will move us closer to that goal."

The plan will give Medicare beneficiaries in the four ZIP codes on the Far North Side another health care choice. No Medicare+Choice organization is in these ZIP codes, but a Medicare PFFS Plan, Sterling Health Plan, currently operates in Illinois.

"We want to make sure all Medicare beneficiaries, whether in a Medicare+Choice plan or fee-for-service, are receiving the highest quality health care," CMS Administrator Tom Scully 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."

President Bush has said the current Medicare+Choice system for paying private plans is not giving beneficiaries the health care options they deserve. Annual increases in Medicare+Choice funding have failed to reflect rising health care costs, leading to unreliable options and reduced benefits for seniors. Under the President's proposal, all Medicare+Choice plans will receive payment increases in 2003.

Medicare+Choice HMOs and fee-for-service plans are available where private companies choose to offer them. Currently, 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, currently chosen by more than 34 million beneficiaries, is available to all beneficiaries.

Congress created Medicare+Choice in the Balanced Budget Act of 1997 to expand the types of health care options available to Medicare beneficiaries, who in addition can now receive new preventive benefits and patient protections. There also is 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 -- http://www.medicare.gov/ -- and a coalition of more than 200 national and local organizations to provide seniors more information.