CYPRESS, Calif., Sept. 28 /PRNewswire-FirstCall/ -- PacifiCare Health Systems Inc. announced that all of its Secure Horizons Medicare Advantage plans have been approved by the Centers for Medicare & Medicaid Services (CMS) to offer Medicare Advantage-Prescription Drug (MA-PD) plans for 2006.
These plans will provide significantly enhanced prescription-drug benefits for its 730,000 Medicare Advantage members in eight states and 82 counties.
When the Medicare prescription-drug benefit (also known as Part D) goes into effect Jan. 1, 2006, all Secure Horizons Medicare Advantage plan members will automatically be provided with this important Medicare drug benefit enhancement. These MA-PD plans combine the medical coverage traditionally provided by Medicare Advantage plans with Medicare’s new Part D prescription drug benefit. This combination will provide even more comprehensive medical benefits than today’s Secure Horizons Medicare Advantage plans. In addition, Secure Horizons has been approved to offer new, enhanced plans that provide lower out-of-pocket costs on major medical services, with the added benefit of prescription drug coverage in the Medicare coverage gap.
PacifiCare currently offers its Secure Horizons Medicare Advantage plans in eight Western states including Arizona, California, Colorado, Nevada, Oklahoma, Oregon, Washington and Texas covering 82 counties.
According to Kathy Feeny, Secure Horizons’ executive vice president, most Secure Horizons Medicare Advantage plans have provided prescription drug benefits to its members for the past 20 years. The addition of the Medicare prescription drug benefit expands this coverage substantially.
“We believe our members will realize tremendous value in our new Medicare Advantage-Prescription Drug plans and appreciate the enhanced prescription drug benefit with lower out-of-pocket costs,” said Feeny. “The Part D prescription drug benefit is integrated into our members’ health care coverage. Our current Secure Horizons Medicare Advantage members need not do anything to begin taking advantage of their new Medicare prescription drug benefit. They do not need to sign up or fill out any paperwork; they are automatically enrolled as part of their Secure Horizons membership.”
PacifiCare expects that nearly all of its Secure Horizons Medicare Advantage members will experience an enhanced benefit plan in 2006 vs. what they currently have. For example, members in 79 counties will have plans offering a $0 deductible for their Part D prescription drug benefit. Nearly two-thirds of PacifiCare’s counties -- 75 percent of Secure Horizons total membership -- will have monthly premiums that are the same as or lower than their 2005 premiums, even after the addition of the prescription drug benefit. Also, 70 percent of members who reside in 38 counties will continue to have a $0 premium for their combined medical and prescription drug benefits. And, in 13 counties, members will see a decrease in their monthly premium from 2005. All Secure Horizons Medicare Advantage members will have access to hundreds more brand-name and generic drugs for lower co-payments than those provided under their current Medicare Advantage plans.
“Under the Medicare Advantage-Prescription Drug program, we are able to enhance their prescription drug coverage beyond that which they normally have today,” said Feeny. “Additionally, we believe that our members will receive prescription drug benefits under the MA-PD program that are more comprehensive and affordable than the standalone Part D benefit available to those covered by original, fee-for-service Medicare.”
Through the Medicare Part D prescription drug benefit, Medicare beneficiaries are guaranteed access to prescription drugs. In addition to providing a new Part D prescription drug benefit, the Medicare Prescription Drug Improvement and Modernization Act, passed by Congress in December 2003, increased funding for Medicare Advantage (formerly Medicare+Choice) health plans. PacifiCare used the additional funds to add new and enhance existing benefits, lower -- and in some cases, eliminate -- premiums and co-payments, and stabilize its networks of doctors and hospitals.
“Congress has modernized the Medicare program, and together with the federal government we are taking action to make prescription drugs more affordable for seniors,” Feeny added. “We have enhanced benefits in areas that members tell us are the most important to them. The additional funding also presents us with opportunities to expand our Medicare Advantage service area and to launch new, innovative programs.”
In 1985, PacifiCare’s Secure Horizons became one of the first Medicare health plans to be awarded a Medicare Risk contract by the federal government. Twenty years later, Secure Horizons remains one of the nation’s largest Medicare Advantage plans, offering competitive health care coverage and additional benefits to nearly 730,000 members in eight Western states.
PacifiCare Health Systems is one of the nation’s largest consumer health organizations with nearly 3.3 million health plan members and approximately 11.3 million specialty plan members nationwide. PacifiCare offers individuals, employers and Medicare beneficiaries a variety of consumer-driven health care and life insurance products. Today, PacifiCare is the nation’s second-largest senior health insurance company with more than 20 years’ experience delivering affordable, quality health care coverage to America’s seniors. PacifiCare’s specialty plan operations include behavioral health and dental and vision, as well as complete pharmacy benefit management with more than a decade of experience specializing in the senior prescription-drug market. More information on PacifiCare Health Systems is available at www.pacificare.com.
PacifiCare Health Systems Inc.
CONTACT: Cheryl Randolph, +1-714-226-3441, cheryl.randolph@phs.com, or DanMiller, +1-714-226-3726, dan.miller@phs.com, both Media Relations ofPacifiCare Health Systems Inc.
Web site: http://www.pacificare.com/
