Observation Stays No Longer Subject to Concurrent Review

IMPORTANT—FirstCare Medicare Advantage Plan Changes

Wednesday, September 28, 2016

Our goal is to provide the best health plan solutions for our members while weighing the financial challenges of declining reimbursement and rising costs. It was difficult, but we made the decision to not renew our Medicare Advantage contract with The Center for Medicare & Medicaid Services (CMS) for 2017.
Our Medicare members will remain enrolled in their current FirstCare Advantage (HMO) coverage—and may obtain services—through December 31, 2016. However, they must choose a new plan for their coverage to continue in 2017. They have from October 15, 2016 – February 28, 2017, to make that selection. All FirstCare Advantage (HMO) members have been notified via letter for receipt no later than October 2, 2016. Copies of the letters are attached for your reference:

FirstCare will continue to pay claims for contracted providers in accordance with the contract and our claims filing guidelines.
This change does not impact any of FirstCare’s non-Medicare members or other lines of business. FirstCare remains committed to the communities we serve, as we work with you to play an important role in providing affordable health care coverage to West Texans.
And, as always, we appreciate your support.
If you have questions, please contact FirstCare Advantage (HMO) Customer Service at 1.866.229.4969 (TTY/TDD 1.800.562.5259). Our lines are open daily Oct. 1 - Feb. 14, from 8 a.m. - 8 p.m. From Feb. 15 - Sept. 30, our lines are open from 8 a.m. - 8 p.m. CT, Monday through Friday. You may also email Provider_Relations@FirstCare.com, or contact your provider relations representative at the number below:
  • Abilene area:               1.325.670.3525
  • Amarillo area:              1.800.239.5650
  • Lubbock area:             1.806.784.4380
  • All other areas:            1.800.431.7737

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