Universal Care to Launch Medicare HMO in Orange, Los Angeles and Kern Counties
Universal Care Inc., a small managed care organization, received federal approval yesterday to operate a Medicare HMO, the Orange County Register reports. The plan can begin accepting enrollees in Orange, Los Angeles and Kern counties today for coverage beginning April 1. Jeff Davis, Universal Care's COO, said that beneficiaries will pay no monthly premium beyond the $54 per month every Medicare beneficiary is required to pay. He added that the HMO will cover unlimited generic drugs and up to $2,000 annually for brand-name drugs, although many brand-name drugs will not be covered. Beneficiaries will pay a $200 co-payment per hospital admission, $10 per doctor visit and $50 per emergency room visit.
The Register reports the new Medicare HMO comes at a time when "many of [Universal's] larger competitors are beginning to eye the exits." Many MCOs have cited "inadequate reimbursement" for their decision to leave the Medicare market. But Davis said, "We believe this is a long-term good market to be in," with a "growing population." According to Davis, Universal chose to launch the Medicare HMO because it "believes the [federal] government will act to safeguard the future of the program." President Bush's fiscal year 2003 budget proposal includes a 6.5% funding increase for Medicare HMOs next year. Davis said, "[W]e expect changes in the Medicare financing of this product that will allow (its continued existence) in the long run to be possible" (Wolfson, Orange County Register, 3/1).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.