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US Fed News

Managed Care Plan Offered To Medicare Beneficiaries In All Municipalities In Puerto Rico

16 November 2004
Copyright © 2004 Hindustan Times. All rights reserved. 

WASHINGTON, Nov. 16 - The U.S. Department of Health & Human Services' Centers for Medicare & Medicaid (formerly the Health Care Financing Administration) issued the following press release:

The Centers for Medicare & Medicaid Services (CMS) today approved a request by Triple-S Inc. to offer managed care coverage to Medicare beneficiaries in all municipalities in Puerto Rico, including the islands of Vieques and Culebra.

Triple-S, a preferred provider organization (PPO) based in San Juan, Puerto Rico, will begin on Jan. 1 serving beneficiaries in every municipality in Puerto Rico including San Juan. Medicare beneficiaries can sign up for the plan during the current open enrollment in Medicare Advantage, formerly known as Medicare+Choice. About 602,000 beneficiaries live in Puerto Rico.

"We are pleased Triple-S decided to offer this health plan to beneficiaries throughout Puerto Rico," HHS Secretary Tommy G. Thompson said. "Under the Medicare reform law signed by President Bush, Medicare will provide all seniors - no matter where they live - with better health insurance options, including prescription drug coverage and preventive care. The law is achieving the President's goals of strengthening and modernizing Medicare."

Triple-S, which does business as Triple-S Medicare Optimo Plan, will give another health care option to beneficiaries in Puerto Rico. Three other Medicare Advantage plans currently operate in Puerto Rico.

"We want to make sure all Medicare beneficiaries, whether in a Medicare Advantage plan or fee-for-service, are receiving the highest quality health care," said CMS Administrator Mark McClellan, M.D., Ph.D. "We are doing more to guarantee that beneficiaries understand the Medicare coverage options available to them. We also are reminding beneficiaries of the need to work closely with the doctors and other health care providers that give them medical care."

Since Dec. 8, when President Bush signed the Medicare Modernization Act into law, CMS has approved 15 new contracts with Medicare health plans and 42 service area expansions. There are currently 40 applications pending for new contracts and 17 service area expansions pending.

Medicare Advantage HMOs, PPOs and fee-for-service plans are available where private companies choose to offer them. Currently, about 4.6 million Medicare beneficiaries - out of a total of about 40 million aged and disabled Americans - have enrolled in Medicare HMOs. Original fee-for-service Medicare, currently chosen by more than 35 million beneficiaries, is available to all beneficiaries.

Medicare has a far-reaching consumer information program that includes a national toll-free phone number - 1-800-MEDICARE (1-800-633-4227) or TTY/TDD, at 877-486-2048 - an Internet site - - and a coalition of more than 200 national and local organizations to provide seniors more information.

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