Trusted local news leader for Kingman, Arizona & Mohave County
Sun, Sept. 15

Medicare PPO to offer prescription coverage

A new health care program with a prescription drug benefit will become available to Mohave County seniors on Medicare beginning January 1.

"Currently there is little available to seniors on Medicare in Mohave County," Doug Eubanks, an administrator for the State Health Insurance Program, said.

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

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

A demonstration program modeled after the preferred-provider organization coverage available to many Americans, Health Net Options Plus offers Medicare beneficiaries in each of these counties an unlimited generic prescription drug benefit, according to information from Health Net.

Health Net of Arizona currently provides health care coverage to approximately 178,000 people through various plans.

The Health Net Medicare+Choice program, which offers Medicare beneficiaries more options and benefits than Medicare provides, is offered in several other Arizona counties but not in Mohave County, Eubanks said.

"This is going to be very beneficial to Medicare recipients who have high prescription drug costs," he said.

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

Eubanks is a program specialist with the Western Arizona Council of Government, which directs the State Health Insurance Program in Mohave County.

The U.S.

Department of Health and Human Services announced Tuesday that the Bush administration has approved a total of 33 new health plans in 23 states.

The new option for preferred-provider organization, or PPO, coverage will be available to about 11 million Medicare beneficiaries – 30 percent of all seniors – in parts or all of the 23 states, which also include California and Nevada.

The plans will begin to serve Medicare beneficiaries in January as part of a demonstration program modeled after the PPO coverage available to Americans with private insurance, Eubanks said.

Additional benefit options, as well as access to affordable prescription drugs, were given by the U.S.

Department of Health and Human Services as reasons for the new plans.

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 under 65 were choosing PPOs, which blend the two approaches.

However, Medicare beneficiaries in Mohave County have been without an HMO plan: 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 closely mirrors the preferred provider type of coverage where consumers have access to any doctor or hospital of their choice.

Consumers pay lower co-payments and receive enhanced benefits when using physicians and hospitals that are part of the health plan's preferred network, according to information from Health Net.

Health Net of Arizona will conduct free seminars in Mohave County to explain the program, its benefits and costs

Open enrollment for the program will be held Nov.

15 until Jan 1.

The Kingman Daily Miner will publish additional information as it becomes available.

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