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Managed Care Plan Expands To Include Medicare Beneficiaries In Indiana County, Pa.

The Centers for Medicare & Medicaid Services (CMS) has approved a request by UPMC Health Plan to expand managed care coverage to Medicare beneficiaries in Indiana County in western Pennsylvania.

UPMC Health Plan, based in Pittsburgh, Pa., can begin serving beneficiaries in Indiana County on June 1, 2003. Medicare beneficiaries can sign up for the plan during the current Medicare+Choice open enrollment. About 15,400 beneficiaries live in the county.

The company began serving beneficiaries in 2001 in seven western Pennsylvania counties including the Altoona-Johnstown area. The plan expanded in 2002 to six counties in the Pittsburgh metro area, including the city of Pittsburgh. The 13 counties the plan currently serves are Allegheny, Armstrong, Beaver, Bedford, Blair, Butler, Cambria, Fayette, Lawrence, Mercer, Somerset, Washington and Westmoreland.

"We are pleased UPMC has decided to expand this health plan to include Medicare beneficiaries in Indiana County," 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 goals for strengthening and modernizing Medicare will move us closer to that goal."

UPMC Health Plan, which does business as UPMC for Life, will give another health care choice to beneficiaries living in Indiana County. Beneficiaries in the county already can choose among three Medicare+Choice organizations.

"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 theneed to work closely with the doctors and other health care providers that give them medical care."

Medicare+Choice 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.

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 and a coalition of more than 200 national and local organizations to provide seniors more information.

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