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SLO County seniors have a new option for their Medicare Advantage provider

Tribune - 10/30/2019

Oct. 30--Seniors have a new option for expanded health care coverage with the addition of a Medicare Advantage plan in San Luis Obispo County.

The company, Humana, has added its Gold Plus HMO Medicare Advantage Plan to the county, which seniors 65 and older can enroll in now through Dec. 7 with no monthly plan premium, although they are still responsible for their Medicare Part A and Part B premiums.

Medicare Advantage plans are offered by private companies that contract with Medicare to provide basic coverage under Medicare's Part A and Part B benefits; most Medicare Advantage Plans also offer prescription drug coverage.

Multiple companies provide Medicare Advantage coverage in SLO County, and Humana is the newest addition.

Under the plan, patients have no copays for primary care or specialists, and $3,000 maximum annual out-of-pocket cost. Acute hospital stays cost patients $285 per day up to five days.

Other benefits through the Humana program include:

-- Choice of a primary care physician from within the plan's provider network

-- Emergency coverage anywhere in the world

-- Prescription drug coverage with no deductible

Humana's Medicare Advantage HMO plan members in SLO County will have access to Coastal Communities Physician Network, a Heritage Provider Network physician group, according to the company.

The way the coverage works is that seniors will keep their Medicare plans, offering coverage for doctor's office visits and hospital stays.

But they gain added benefits through Humana for over-the-counter drugs and supplies; free rides to plan-approved locations; regular hearing screenings and coverage for hearing aids; and memberships to fitness centers through its SilverSneakers program.

The goal of the coverage is to allow patients to spend more time with their doctor and focus on preventive health care.

Humana receives reimbursements from the federal government to provide its services, according to company officials.

Rick Beavin, California's market president for Humana, told The Tribune that SLO County has a significant senior population that could take advantage of the coverage.

"There are about 75,000 Medicare-eligible people in SLO County, and relatively few take part in Medicare Advantage," Beavin said. "We're very excited about the opportunity of entering the county and providing a needed and valuable benefit."

Humana also offers programs to reduce costs for low-income seniors.

"Heritage Provider Network is very pleased to expand our relationship with Humana," said Richard Merkin, president and CEO of Heritage, in a statement. "Over the last 40 years we have focused on developing care management solutions that improve the health and well-being of the people we serve. We are excited to now be able to offer these solutions to Humana's Medicare Advantage members in San Luis Obispo County."

For more information about enrolling in any Humana plans, visit or call 1-800-213-5286 (TTY: 711), Monday through Friday from 8 a.m. to 8 p.m. local time.


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