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Johns Hopkins HealthCare Enters the Medicare Advantage Market

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Johns Hopkins HealthCare Enters the Medicare Advantage Market

Johns Hopkins HealthCare Enters the Medicare Advantage Market

Date: 11/30/2015

Johns Hopkins HealthCare has introduced two Medicare Advantage health care plans: Johns Hopkins Advantage MD and Advantage MD Plus. Medicare Advantage plans are offered by private companies that contract with the Centers for Medicare and Medicaid Services to provide both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) to adults 65 and older who enroll. Both plans will also cover prescription drugs, unlike regular Medicare.

Given the aging of the population — about 10,000 Americans reach 65 every day — Johns Hopkins HealthCare saw this as an opportune time to enter the Medicare Advantage market. In addition to the growing market, Maryland has one of the lowest Medicare Advantage penetration rates in the country: Only 11 percent of the eligible population is enrolled in a Medicare Advantage plan, compared with the national average of 34 percent. Approximately 900,000 Marylanders are currently eligible for Medicare.

“Johns Hopkins Advantage MD is the only Medicare Advantage plan in Maryland that provides members with the complete suite of Johns Hopkins providers and hospitals, plus access to thousands more throughout the state,” says Victoria Fretwell, vice president of program development and chief of staff at Johns Hopkins HealthCare. Members can talk to a nurse 24/7 and get help setting up an initial appointment with Johns Hopkins specialists through a specialty appointment line.

Advantage MD, a preferred provider organization (PPO) plan, will provide comprehensive benefits, including coverage for doctor and specialist visits, prescription drug coverage, preventive care, outpatient surgery, urgent and emergency care, diagnostic services, chiropractic care and acupuncture. It also covers preventive dental, routine vision and hearing, and home health care.

Also a PPO plan, Advantage MD Plus will offer the same coverage as Advantage MD, but members can also join the Silver&Fit fitness program — which offers free access to participating exercise centers — and will have access to hearing aid services and lower copays on many services.

“The plans let us take a coordinated approach to care. Our physicians talk to one another, which will reduce duplicative and unnecessary testing. We have care managers already positioned in a number of our practices, allowing us to take a collaborative approach to managing individuals as well as the population,” Fretwell says.

Johns Hopkins HealthCare established a subsidiary called Hopkins Health Advantage Inc. to hold the insurance license for the plans.

Annual open enrollment is Oct. 15 to Dec. 7. Coverage begins Jan. 1, 2016. Individuals who age into Medicare eligibility during the year can buy either plan outside the enrollment period. Both plans will serve Baltimore City as well as Anne Arundel, Baltimore, Calvert, Carroll, Howard, Montgomery, Somerset, Washington, Wicomico and Worcester counties.

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