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Anticipating a trend toward increasing use of fee-for-service payments, the Health Care Financing Administration last year approved a request by the Sterling Life Insurance Company of Chicago to offer the first private fee-for-service health plan option for Medicare patients. The plan is now available in 17 states. Medicare participants enrolling in the new private fee-for-service plan will not be restricted to a network and may get health care services from any Medicare-eligible provider in the country.
Sterling’s fee-for-service option provides coverage for all Medicare Part A and B services, plus worldwide emergency care and coverage of increased inpatient hospital days. Providers who choose to provide care to beneficiaries enrolled in a private fee-for-service plan will be paid on a fee-for-service basis by the plan and are not subject to utilization review.
This is the first private fee-for-service plan to apply under the Medicare+Choice program. The Sterling plan will be offered primarily in rural areas where Medicare+Choice options have not been widely available. It is expected to be popular with beneficiaries in these areas.
States where the plan will be available are: Alaska, Idaho, Kentucky, Minnesota, Nebraska, Nevada, New Mexico, Oregon, South Dakota, Tennessee, and Utah. It will also be offered in selected counties in Arkansas, Louisiana, Mississippi, Ohio, Texas, and West Virginia. Contact your local Medicare carrier for more information.