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Life Health > Health Insurance > Life Insurance Strategies

Humana To Administer Coverage For SunCoast Members

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A large insurer has described the coverage continuation benefits it will provide for 600 members of a failed Medicare health maintenance organization.

Humana Inc., Louisville, Ky., is taking responsibility for covering the Medicare beneficiaries. The beneficiaries previously were members of the Medicare HMO run by SunCoast Physicians Health Plan Inc., Weston, Fla.

The federal Centers for Medicare & Medicaid Services ended its relationship with SunCoast Friday, when Florida regulators put SunCoast into receivership, Humana says.

Humana now administers health coverage for 125,000 Medicare beneficiaries living in Florida.

Humana will let current SunCoast HMO members pay in-network rates to see their current providers, whether the providers are in or outside of the Humana Medical Plan network, at least until Oct. 31, Humana says.

SunCoast members now receiving treatment for chemotherapy, radiation therapy, end stage renal disease dialysis or organ transplantation will continue to receive SunCoast benefits already prescribed at Humana plan network cost-sharing amounts until the treatment ends or, if the treatment continues past the end of the year, until Dec. 31, Humana says.

The SunCoast plan members can use SunCoast formulary drugs until Humana can shift them to the Humana formulary, Humana says.

SunCoast plan members who have questions about the changes can call Humana at (800) 819-6931.


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