Columbia, S.C. – More than 40,000 Medicare beneficiaries in South Carolina with private Medicare Advantage plans that do not use a network of doctors and hospitals are learning that they must move to a plan with a contracted network of providers for 2011.
Their plans are no longer available in South Carolina due to new federal rules imposed under the Medicare Improvements for Patients and Providers Act of 2008 (MIPPA). Members in these plans have a special election period beginning Oct. 1 and ending Jan. 31, 2011. Medicare Advantage members who are already in network plans can sign up Nov. 15 – Dec. 31 during the regular annual election period.
BlueCross BlueShield of South Carolina hopes to be able to serve the diverse needs of these additional members by offering three Medicare Advantage PPO (preferred provider organization) plans, which have networks of doctors and hospitals across the state and elsewhere.
Under the company’s Medicare BlueSM program, one of the plans offers medical coverage while the other two offer medical and pharmacy coverage.
BlueCross encourages all Medicare Advantage beneficiaries to inquire now for information. Individuals may contact their insurance agents or contact BlueCross toll free at 800-930-2912 (TTY 800-681-3846). The company also plans to host public seminars.
“We offer a strong statewide provider network, and individuals on our plans also have network access in 29 other states, which is important for those who travel or reside part of the year elsewhere,” said BlueCross BlueShield Division President Jim Deyling. “In addition, new enrollees to Medicare often find the options confusing, so we are prepared to help them understand what Medicare Advantage plans are in general.”
Medicare recipients may opt for original Medicare, with which they often purchase a Medicare Supplement plan to cover what Medicare does not. Or, Medicare recipients may choose a Medicare Advantage plan, available from private insurance companies, encompassing original Medicare and supplemental coverage as well as additional benefits. For instance, BlueCross includes dental and vision on some Medicare Advantage plans.
Medicare Advantage plans may or may not require monthly premium payments, depending on the member’s subsidy status and the county in which the member resides. Most are designed so a member will pay a copayment or some out-of-pocket cost when his or her physician provides medical services. BlueCross provides a summary that shows what services are covered and at what copayments, and it shows which providers are in its statewide PPO plans.
Headquartered in Columbia, S.C., BlueCross BlueShield of South Carolina is an independent licensee of the Blue Cross and Blue Shield Association. The only South Carolina-owned and operated health insurance carrier, BlueCross BlueShield of South Carolina comprises more than 30 companies involved in health insurance services, U.S. DoD health program and Medicare contracts, other insurance and employee benefits services, and a philanthropic foundation that funds programs to improve health care and access to health care for South Carolinians.