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Medicare News

For Immediate Release: Contact:
Wednesday, June 02, 2004 CMS Office of Public Affairs
202-690-6145

For questions about Medicare please call 1-800-MEDICARE or visit www.medicare.gov.

PHYSICIAN-OWNED MANAGED CARE PLAN OFFERED TO MEDICARE BENEFICIARIES WITHIN ST. LOUIS, MO. METRO AREA

The Centers for Medicare & Medicaid Services (CMS) today approved a request by Essence Inc. to offer managed care coverage to Medicare beneficiaries within the St. Louis, Mo., metro area, including the city of St. Louis.  

 

Essence Inc., a physician-owned plan based in St. Louis, is now serving beneficiaries in St. Louis, St. Louis City, Jefferson and St. Charles counties.  Medicare beneficiaries can sign up for the plan during the current open enrollment for Medicare Advantage, formerly known as Medicare+Choice About 275,000 beneficiaries live in the plan’s service area.

                  

"We are pleased Essence Inc. decided to offer this health plan in the St. Louis area,” HHS Secretary Tommy G. Thompson said.  "Under the Medicare reform law signed by President Bush, Medicare will provide all seniors - no matter where they live - with better health insurance options, including prescription drug coverage and preventive care.  The law is achieving the President's goals of strengthening and modernizing Medicare.”

 

Essence Inc., which does business as Essence Healthcare, will give beneficiaries in the St. Louis area another health care option to select. The other companies currently offering Medicare Advantage options in the same service area as Essence are Group Health Plan, Mercy Health Plans and United Healthcare.    

 

“We want to make sure all Medicare beneficiaries, whether in a Medicare Advantage plan or fee-for-service, are receiving the highest quality health care," said CMS Administrator Mark McClellan, M.D., Ph.D.  "We are doing more to guarantee that beneficiaries understand the Medicare coverage options available to them.  We also are reminding beneficiaries of the need to work closely with the doctors and other health care providers that give them medical care."

 

Medicare Advantage 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.

Medicare has 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 -- www.medicare.gov -- and a coalition of more than 200 national and local organizations to provide seniors more information.

 

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