Good news for El Paso’s Medicare beneficiaries suffering from chronic illnesses. They are now able to get the services of an insurance plan called Care Improvement Plus that specializes in chronic illness needs.
Hortencia Hernandez, 80, who is living with diabetes, is a current member of Care Improvement Plus, a Medicare Supplement Plan which has helped her learn how to deal with this illness. “Even though I visit my doctor and ask him to answer some of my questions, sometimes he can’t dedicate the time I need. But I am able to call Care Improvement Plus and they are able to help me with any doubts or concerns I might have,” Hernandez said.
Care Improvement Plus, is a unique
Medicare health plan, designed to
meet the specific needs of Medicare
beneficiaries living with diabetes,
heart failure, chronic obstructive and
pulmonary disease.
Jean Schiffer, a marketing manager for Care Improvement Plus said, “lots of times people don’t know how to prevent certain diseases or how to treat them.” The plan was designed to educate people with chronic illnesses and in return provide managed care to make the cost more affordable and in the long run not only for medical beneficiaries but for the federal government as well.
Hortencia Hernandez as well as Estella, 60, are some of the many El Pasoans who are currently enrolled in the plan. There are approximately 1,500 people enrolled in El Paso alone, and about
10,000 people enrolled in the state of
Texas. Access to health care is a serious
problem affecting the U.S – Mexican
border.
El Paso Texas, a border city with Mexico,
who has large number of Hispanics in need
of health care. According to a market
assessment from XL Health, “73% of 65+.
In El Paso use Medicare as their insurance program and 17% use Medicaid or some other public assistance program.”
According to Schiffer, “in El Paso, 28 percent of those 65 and older have reported having heart problems, heart disease and stroke and these were the leading cause of death in El Paso County in 2004.” Research also indicates that Hispanics are more likely to suffer from diabetes than non-Hispanic whites. In addition, 21.4 percent of Hispanics aged 65 and older have been diagnosed with diabetes, the fourth leading cause of death among Hispanics.
The representatives of this plan like Jean Schiffer are in charge of going into the community outreaching to them to get people to understand and enroll in this plan. They go to many places like Thomason Hospital, Texas Tech, restaurants and other places to explain and present to people the uniqueness of this plan.
Estella, 60, found out about the plan
like many others by attending a
meetings at Golden Corral restaurant.
“I feel very comfortable and I feel like
I get a lot of attention with Care
Improvement Plus. Out of all the
companies that have spoken to me about enrolling in their plan, this is the
one that caught my attention because of all the benefits, I am very happy right now” Estella said.
The plan provides prescription drug coverage, routine physical exams at no charge, fixed co-pays, nurse coaching, support services at little or no cost, and in home health monitoring. This plan is one of many Medicare supplement plans, but it differs from others because it is only offered to those living with chronic health conditions and it is an open network where the members can go to any hospital or physician of their choice as long as they are Medicare certified. There are three plans in Care Improvement Plus. that are provided. The first one is the Silver plan, which is for Medicare and Medicaid beneficiaries. The Silver plan offers zero co-pays because whatever Medicare doesn’t pay, Medicaid covers. The second is the Gold plan, which gives people three options to choose from and includes fixed co-pays. The Gold plan costs from $19 to $66 per month. The third plan is called the Platinum plan, which also offers threes options. The Platinum plan costs from $96 to $130 per month, and it gives people high or premiums for people who prefer to pay no co-pay and offers more coverage for medication.
Care Improvement Plus Medicare advantage plan was created because the original Medicare program from the federal government was spending too much money on the patient’s medical bills. In other words this insurance plan gets reimbursed from Medicare for the expenses that are made. 80% of the beneficiaries from Medicare that have a chronic disease form the 99% total costs for the Medicare program. Each member of Care Improvement Plus is assigned to a care coordination team which will work with the member and the doctors to assure the best quality care. This helps our members avoid hospitalizations and at the same time control costs.
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