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PacifiCare Adds Medigap Products

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NU Online News Service, Sept. 5, 12:04 p.m. – PacifiCare Health Systems Inc., Santa Ana, Calif., says it is ready to begin selling its new individual Medicare supplement products in California, Arizona, Nevada and Oklahoma.

PacifiCare Life and Assurance Company, the subsidiary that writes the coverage, now has approval to market the new Secure Horizons Medicare Supplement policies in those four states, and it has applied for permission to sell the policies in three other states, PacifiCare says.

PacifiCare has long been known as a seller of tightly managed commercial and Medicare health maintenance organization plans that paid many participating primary care doctors flat fees for each patient served. Now it is trying to branch out into selling more loosely managed plans that pay doctors fees for each service delivered.

The company hopes to enroll 1 million members in the Medigap plans by 2007.

The Secure Horizons Medigap plan is a fee-for-service plan. It does not include prescription drug coverage, but it does include a package of “buyer’s club” discounts on prescriptions, over-the-counter medications, hearing aids, and other products and services.

The federal government limits issuers of Medigap policies to selling 10 standard plans, which are identified by letters.

The new Secure Horizons Medigap program will include Medigap plans A, C, F and G.

Plan A is a basic plan that covers hospital and physician coinsurance. The other plans offer more benefits, such as coverage for skilled nursing care while patients are recovering from conditions such as strokes.

PacifiCare Life will being enrollment in the Medigap plans in mid-September. Policies will begin taking effect in October.

Prices will be based on the type of plan selected, the rating region, and use or non-use of tobacco.

A 65-year-old non-smoker living in the Oklahoma City and Tulsa areas, for example, will pay $80 for Plan A and $122 for Plan C or F. In other counties, that same individual might pay $76 for Plan A and $122 for Plan C or F.