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Fox Insurance Company Decision To Drop Medicare Provider Will Affect 10,000 People

Originally Posted: March 18, 2010

New York City - Nearly 10,000 Medicare Part D enrollees living in all of New York State's 62 counties will be affected by a decision of the federal Centers for Medicare & Medicaid Services (CMS) to cancel coverage provided through Fox Insurance Company, the New York State Insurance Department said today.

"The Insurance Department urges enrollees covered through Fox to look for letters being mailed to them this week by CMS explaining the agency's decision to cancel Fox and the options now available to them. People need to understand their options so they don't experience any delay in getting their prescription drugs," Insurance Superintendent James Wrynn said.

Fox's contract was canceled by CMS because the insurer improperly denied prescription drug benefits to enrollees. Coverage will now be provided through the Humana LI-NET program.

A total of 9,895 New Yorkers are affected. More than half of these people reside in the New York City, Long Island and the Lower Hudson River Valley counties. Other large concentrations of enrollees reside in Erie County, 414 people; Onondaga County, 254 people; and Monroe County, 280 people.

Network pharmacies are being advised to accept Fox Medicare cards for automatic coverage under LI-NET.

Affected Fox enrollees must receive their drugs through LI-NET through March 31, although they can remain in LI-NET, which has an open formulary, through April 30. Enrollees can then opt to choose another prescription drug provider during the Medicare Part D special enrollment period which ends June 30. If enrollees do not choose another plan by April 30, CMS will automatically enroll participants with another prescription drug provider with benefits comparable to those under their old Fox plan.

Additional information can be obtained by contacting 1-800-MEDICARE (1-800-633-4227) or the New York State Health Insurance Assistance Program (NYSHIP) at 1-800-701-0501.

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