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Oneida
County seniors to be eligible for Medicaid HMO in July
June 26, 2003
MARRECCA
FIORE
Observer-Dispatch
UTICA -- Starting next month, Medicare-eligible
senior citizens in Oneida County will have the option
of getting their coverage through an HMO.
UnitedHealthcare
of New York has been approved by the U.S. Department
of Health and Human Services to offer Medicare HMO coverage
in Oneida and Onondaga counties beginning Tuesday, July
1. Medicare is a federal health insurance program available
to senior citizens and disabled Americans.
UnitedHealthcare,
which already provides coverage to seniors in the New
York City area, decided to offer the plan in Central
New York because a need exists, one official said.
"We
took a market analysis within New York State ... and
looked at communities that did not have a lot of options
for Medicare outside of the traditional federal program,"
said Keith Gordon, the insurer's executive director
for New York. "You have 120,000 eligible seniors
in Oneida and Onondaga counties and we thought it would
be a good opportunity for us to come in and offer our
products and services."
The
advantage of having a Medicare HMO, rather than a traditional
Medicare program, is that the plan is more inclusive,
he said.
"(Seniors)
would still need to pay the Medicare Part B premium
of $58.70 each month, but in this kind of program everything
else is inclusive and there are very minimal out-of-pocket
expenses," Gordon said. "This is a much more
comprehensive plan and includes all the preventive benefits
as well."
Under
the HMO plan, seniors do not need a referral to see
a specialist, but must use healthcare providers within
the HMO network, Gordon said. There is also a prescription
drug benefit and a "passport program" allowing
seniors to see doctors in other states who belong to
the UnitedHealthcare Medicare HMO network.
Medicare
will pay the HMO $564.10 a month for each senior in
the two-county area that enrolls in the program, Gordon
said. In traditional Medicare programs, the federal
government pays doctors directly on a per visit basis.
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