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Sun, Sept. 15

PPO plan with prescription drug coverage available to seniors on Medicare after first of year

Seniors on Medicare can begin signing up for a plan that provides prescription drug coverage - and allows them to choose their own health care provider.

The demonstration program - modeled after the preferred provider organization coverage available to many Americans will become available to Mohave County seniors on Medicare beginning Jan.


"This plan will be especially beneficial to Medicare recipients who have high prescription drug costs," Doug Eubanks, the program specialist for the State Health Insurance Program (SHIP), though the WACOG Agency on Aging, said.

"They can finally receive help with some of their expenses."

Health Net of Arizona will offer Health Net Options Plus in seven Arizona counties, including Cochise, Coconino, Gila, Maricopa, Mohave, Pima and Pinal.

Medicare beneficiaries in each of these counties will have access to an unlimited generic prescription drug benefit.

The cost of the plan is $159 a month, but covers all generic drugs, including a 31-day supply with a $10 to $20 co-pay, or a 93-day prescription with a $24 co-pay, Eubanks said.

"Mohave County seniors on Medicare have been limited in terms of a health care plan, with Medigap or supplemental policies through the private market their only choices," he said.

"This program will offer Medicare beneficiaries a health care plan with access to the prescription drugs they need."

Until now, Medicare beneficiaries generally could only choose between two models of care - fee-for service coverage or a closed network health maintenance organization (HMO) - while many Americans have PPO coverage, which blends the two approaches.

Medicare beneficiaries in Mohave County have been without an HMO plan since Premier Healthcare went bankrupt and stopped doing business in the county more than two years ago leaving thousands of seniors with reduced coverage, Eubanks said.

Health Net Options Plus - a demonstration program modeled after the PPO coverage available to Americans with private insurance - is one of 33 new health plans in 23 states, the U.S.

Department of Health and Human Services announced.

Additional and better benefit options, as well as access to affordable prescription drugs were given as reasons for the new plans.

Seniors on Medicare can enroll in the program before Jan.

1 by calling 1-888-939-1551.

A community council meeting to explain the program and provide more information on benefits and costs will be held at 10 a.m.

Tuesday at the Kathryn Heidenreich Senior Center.

Hosted by Western Arizona Council of Governments, the purpose of the meeting is to update seniors on Health Net Options Plus and prescription drugs, Eubanks said.

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