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News & Publications

Entering the Medicare Market

By Kris Moody on 10/30/2015
Published in Dome - November 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 to provide both Medicare Part A (hospital insurance) and Medicare Part B (medical insurance) to adults 65 and older. Both plans will also cover prescription drugs.

Johns Hopkins HealthCare saw this as an opportune time to enter the Medicare market, with about 10,000 Americans reaching age 65 every day. 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.

“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 will also be able to talk to a real nurse 24 hours a day, seven days a week and get help setting up initial appointments with Johns Hopkins specialists through our no-cost specialty appointment line.”

To create the new plan, Johns Hopkins HealthCare established a subsidiary company called Hopkins Health Advantage Inc., which holds the insurance license for the Medicare Advantage plan.

Advantage MD, a preferred provider organization 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.

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.

Annual open enrollment is Oct. 15 to Dec. 7. Coverage begins Jan. 1, 2016. Both plans will serve Baltimore City as well as Anne Arundel, Baltimore, Calvert, Carroll, Howard, Montgomery, Somerset, Washington, Wicomico and Worcester counties.