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The Health Care Financing Administration (HCFA) is responsible for administering the health benefits under Medicare for Medicare beneficiaries. This includes both original Medicare and Medicare+Choice (HMo) Plans established under the Balanced Budget Act of 1997.
HCFA
required all Medicare+Choice Plans to submit their 2001 changes to service areas
and plans of benefits by July 3, 2000.
Some plans are withdrawing from the program altogether. These are referred to as
Non-Renewals. Other plans are staying in the program, but are withdrawing from
serving certain areas. These are referred to as Service Area Reductions. These changes will be effective January 1, 2001.
The detailed plan change information is available
in this web site as well as in the HCFA website (http://www.hcfa.gov/medicare/mcfactf.htm)
or you can call 1-800-MEDICARE (1-800-633-4227) for information about a specific Medicare+Choice Plan.
HCFA released the following statement on July 24th, 2000, regarding non renewals and service area reductions of plans: "Consistent with recent reports, in 2001, about 85 percent of current Medicare+Choice beneficiaries will be able to continue with their current Medicare HMO. Sixty-five Medicare+Choice HMOs chose not to renew their Medicare+Choice contracts and 53 reduced their service areas, affecting more than 934,000 Medicare beneficiaries. About 775,000 of the affected beneficiaries will be able to enroll in another Medicare HMO, if the HMO is accepting enrollees. About 17 percent or 159,000 of the remaining beneficiaries will be left with no Medicare+Choice HMO options, although some may choose to enroll in a private fee-for-service plan if one is available in their community. All beneficiaries who are affected by these nonrenewals may return to original fee-for-service Medicare." Refer to the Summary Tables below for additional summary statistics.
If
you are currently a member of a Medicare+Choice Plan your plan must notify you
in writing of any changes in benefits or service area reductions effective
January 1 no later than
October 2, 2000.
During November, the annual open enrollment period begins for the 2001 benefit year for all Medicare beneficiaries. Medicare Beneficiaries covered under a plan during 2000 that is ceasing to provide coverage in 2001, and who do not enroll in another Medicare HMO by January 1st 2001 will automatically be covered under traditional Medicare Part A and Part B, may apply for guaranteed issue Medigap policies through March 4, 2001.
Summary of Medicare HMO market withdrawals effective January 1, 2001
Click here for Summary Statistic Tables
| Parent Company | % Exiting | Summary | Withdrawal Information |
| Aetna | 53.9% | Exiting 11 states plus 23 counties in three additional states effecting 355,000 members. Remaining in selected markets in 5 states serving 304,000 members. |
|
| Cigna | 67.5% | Exiting 11 states with 104,000 members. Remaining in New Mexico and Arizona markets serving 50,000 members. |
|
| Foundation Health | 7.3% | Exiting 18 counties in AZ, CA, CT, NJ, NY and PA. with 19,000 members. Remaining in 36 counties in AZ, CA, CT, FL, NY and PA serving 240,000 members. |
|
| Humana | 16.2% | Exiting 45 counties with 84,000 members. Remaining in all 9 states in selected markets serving 434,000 members. |
|
| Oxford Health | 8.3% | Exiting eight New Jersey counties with 7,200
members. Remaining in New York and Connecticut and selected New Jersey
markets serving 80,000 members. |
|
| PacifiCare | 2.7% | Exiting 15 counties in 5 states affecting more 26,600 members. Remaining in all states but Ohio ( 8 total ) serving 968,000 members. |
|
| United HealthCare | 14.1% | Exiting 21 counties affecting 56,000 members; remaining in 61 counties serving 340,000 members | |
| Other Plans
(This is only a partial listing, that includes selected prominent plans) |
NA | Anthem Blue Cross and Blue Shield of Connecticut, AvMed Health Plan, CareFirst BlueCross BlueShield, Harvard Pilgrim, Kaiser Permanente, HealthGuard, Medica, Ochsner Health Plan, Premera Blue Cross, Providence Health Plans, Regence BlueShield, Sierra Health Services | Click here for Detailed Table |
HCFA INFORMATION ABOUT PLAN WITHDRAWALS FOR 2001
The
following links take you to the HCFA website which provides consumer information
about Medicare+Choice Plan Withdrawals for 2001.
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