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Medicare Roundup

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Units of WellPoint Inc. are trying to offer of peace of mind for Medicare managed care plan members who seek out-of-network care.

The WellPoint Anthem Blue Cross and Blue Shield plans in Indiana, Kentucky and Ohio will be introducing the Blue Medicare Access Standard plan, a Medicare preferred provider organization plan that will charge a set co-payment for most out-of-network care, according to WellPoint, Indianapolis.

The co-payment will be higher than the co-payment for in-network care, but consumers who buy the plan, which will take effect in January 2007, will not face the uncertainty of having to pay a coinsurance amount that is set to be a percentage of the billed amount, WellPoint says.

The plan also will include Medicare Part D prescription drug coverage and routine vision coverage, WellPoint says.

In other Medicare plan news:

- Care Improvement Plus, Baltimore, is starting to sell Medicare “special needs” plan coverage in Arkansas, Georgia, Missouri, South Carolina and Texas.

The plan is part of an effort by Medicare administrators to test the idea of offering managed care plans for Medicare beneficiaries with chronic illnesses.

The Care Improvement Plus plan is open to Medicare beneficiaries with diabetes, heart failure, chronic obstructive pulmonary disease or end-stage renal disease.

The plan also is available in 8 Maryland counties for Medicare beneficiaries with diabetes, heart failure or end-stage renal disease.

Plan features include $0 premiums and co-payments, nursing support in person or by the telephone, and free transportation services, according to Care Improvement Plus.


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