Blue Cross and Blue Shield of Mass. to offer Blue Care 65, a new statewide managed care plan for medicare beneficiaries; New plan offers coordinated, comprehensive benefits, preventive care and low cost.
According to BCBSMA President and CEO William C. Van Faasen, the federal Health Care Financing Administration (HCFA) has approved BCBSMA's application to offer managed health coverage for individuals entitled to Medicare. Effective immediately, Blue Care 65 will be available through a network of provider groups across the state, including Partners Community HealthCare, Inc. (PCHI). Blue Care 65 is a statewide managed care plan for Medicare beneficiaries available in Massachusetts.
Blue Care 65 is based on the HMO Blue network. Currently, more than 75 percent of Blue Cross and Blue Shield's HMO Blue for Seniors members receive their health services at one of the nine BCBSMA health center locations.
"For more than 30 years, Blue Cross and Blue Shield has been a leader in serving the health care needs of Medicare beneficiaries," said William C. Van Faasen, BCBSMA president and CEO. "The introduction of Blue Care 65 further demonstrates our commitment to providing Medicare beneficiaries with quality health care at a price they can afford. Working with Partners, we have designed a product that offers Medicare beneficiaries access to a statewide network of experienced, caring physicians and world-renowned teaching hospitals and prestigious community hospitals."
"Last January, Partners and BCBSMA announced a strategic alliance, an important part of which was to be the cooperative development of a product for the Medicare population. Today, we announced the realization of that promise with Blue Care 65," said H. Richard Nesson, MD, chairman, Partners Community HealthCare, Inc. and CEO, Partners HealthCare Systems, Inc.
"Partners Community HealthCare, Inc. will be an important part of the care delivery for Blue Care 65. Not only will our physicians comprise about half of the Blue Care 65 network, we will also have unique responsibilities focusing on shared provider services, medical management, and information sharing throughout the healthcare network," said Ellen Zane, CEO, PCHI and Network President, Partners HealthCare System, Inc.
Blue Cross and Blue Shield will provide Blue Care 65 members with all their Medicare-covered services, plus routine checkups, hearing and eye exams, and generous allowances toward hearing aids and eyeglasses; unlimited hospitalization, as well as additional health and wellness programs.
"This new managed care plan for Medicare beneficiaries, Blue Care 65, will allow people with Medicare to receive the coordinated care they need to promote their highest level of well-being. The plan encourages patients to see their doctor more regularly, helping to deliver and coordinate the best treatment available, whether it's routine or highly specialized services in a health center or physician office," said John Collins, MD, Medical Director, Health Centers Division, Physician Partners of New England.
Individuals who are entitled to Medicare may select the zero premium Blue Care 65 Value plan which offers comprehensive health care and access to many of the state's best physicians, hospitals and health centers. Medicare beneficiaries must continue to pay their Medicare Part B premium.
In Bristol and Barnstable counties, Blue Care 65 is available for a $30 monthly premium. In western Mass., in Berkshire, Franklin, Hampden, and Hampshire counties, the Blue Care 65 Value plan is available for a monthly premium of $20. Members looking for prescription drug coverage may choose the new Blue Care 65 Value Plus plan, which provides comprehensive prescription drug and routine dental coverage, for an additional $60 monthly premium.
Blue Care 65 members pay a $5 co-pay fee for each doctor's visit and their are no deductibles and virtually no claim forms.
The Blue Care 65 network includes more than 4,000 primary care physicians and specialists, 45 hospitals, 57 skilled nursing facilities, and more than 2800 ancillary providers.
"The introduction of Blue Care 65 is a preview of BCBSMA's long-range strategy to provide Medicare beneficiaries with quality health care," said Gerard Roche, senior vice president of BCBSMA' senior division. "Our coordinated approach to overall prevention, early detection and treatment will ensure that Blue Care 65 members receive the best possible health care at the lowest possible cost," he said.
Members joining Blue Care 65 will select a primary care physician, who will provide all routine medical care, except for emergency or out-of-area urgently needed care. Blue Care 65 members may choose a primary care physician practicing in their community or at one of BCBSMA's nine health centers located statewide.
The primary care physician will coordinate all medical services and refer patients to appropriate specialists within the Blue Care 65 network.
The BCBSMA health centers will provide members with all their routine health care needs on-site, including laboratory and x-ray services, women's health care services, vision and hearing care, and pharmacy services. Evening and weekend appointments at the health centers are available for Blue Care 65 members. Blue Care 65 will also offer its members ongoing health and wellness education, nutrition and other prevention programs.
Roche said, "Blue Care 65 offers the kind of quality health care Medicare beneficiaries need. With Blue Care 65, people with Medicare won't have to navigate an increasingly complex health care world on their own. Their personal physician will coordinate care. We've created a health care plan that meets the needs of today's older adults."
BCBSMA is anticipating that members enrolled in the HMO Blue for Seniors plan will upgrade to Blue Care 65, which offers expanded coverage, at a lower price. Current HMO Blue for Seniors members will be notified beginning today of opportunities to obtain more information and join Blue Care 65.
"Blue Cross and Blue Shield's popular indemnity plans for Medicare beneficiaries, Medex Gold, Bronze, and Core will continue to be offered to individuals who want fee-for-service care," Roche said.
BCBSMA is the region's largest health services company, providing a full range of managed care and traditional benefits, products and services to business organizations and individual customers, to health care providers and to federal, state, and local governments.
PCHI is the corporation responsible for developing an integrated health care delivery system for Partners HealthCare System, Inc. The PCHI network includes primary care physicians and specialists, community hospitals. Partners' two founding academic medical centers Brigham and Women's Hospital and The Massachusetts General Hospital, specialty facilities, community health centers and other health-related entities throughout Eastern Massachusetts. PCHI's design is to integrate care and thereby enhance the health status to the population it serves.
CONTACT: BlueCross BlueShield of Mass.
Ethel Shepard, 617/832-4826
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|Date:||Jan 29, 1996|
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