UCLA is offering its own Medicare Advantage Plan to the general Medicare-eligible population in LA County. This plan should not be confused with the UC Medicare Advantage Plan offered to UC retirees. From Regents item H3 to be discussed at the Regents today:
...UCLA Health will launch its Medicare Advantage health plan under the name “UCLA Health Medicare Advantage Plan” on January 1, 2025, through New Century Health Plan, Inc. (NCHP). NCHP was established on July 6, 2023, as a California general business corporation wholly owned by the Regents of the University of California. Licensed by the California Department of Managed Health Care (DMHC) under the Knox-Keene Health Care Service Plan Act of 1975, NCHP is a fully authorized healthcare service plan provider offering comprehensive services to Medicare beneficiaries across all zip codes within Los Angeles County. NCHP’s Medicare Advantage and Prescription Drug (MAPD) plan bid was approved by the Centers for Medicare and Medicaid Services (CMS) on August 21, 2024. A calendar year contract for 2025 with CMS was executed on August 27, 2024, allowing NCHP to provide services to enrolled members on January 1, 2025.
===
...The UCLA Health Medicare Advantage Plan offers two health maintenance organization (HMO) plans that meet the diverse needs of the Los Angeles County Medicare beneficiary market. The approach was to design affordable plans with predictable costs by offering low monthly premiums and an over-the-counter smart benefits card to keep out-of-pocket costs low. In addition to prescription drug coverage, both plans include dental, vision, and hearing benefits, along with fitness and nutrition services to support holistic health. The inclusion of transportation services in the benefits ensures accessible and reliable transportation to and from medical appointments, addressing a critical barrier to care that disproportionately affects underserved communities. Both plans are financially sustainable and market competitive.
Prescription Drug Benefits
The health plan includes full Part D prescription drug benefits, ensuring that members can access a comprehensive range of medications. The plan’s pharmacy benefits manager (PBM), MedImpact Healthcare Systems, Inc. (MedImpact), a California-based organization with a vast network of pharmacies, will administer these benefits. Medimpact’s services include retail, specialty, and a mail-order pharmacy through BirdieRx, making prescription fulfillment convenient and accessible for members across Los Angeles County.
Full Regents item at https://regents.universityofcalifornia.edu/regmeet/nov24/h3.pdf.
==
PS: I am told UC-San Francisco looked into creating a similar Medicare Advantage plan and found that the difficulties involved could not be overcome.
No comments:
Post a Comment