Leon Medicare patients to be treated at some Baptist hospitals
Baptist Health South Florida and the Medicare Advantage plan of Leon Medical Centers announced Monday that the plan’s approximately 45,000 members can go to some of Baptist’s hospitals starting next year.
Under the arrangement, patients enrolled in Leon Medical Centers Health Plans, an HMO in partnership with Cigna HealthSpring, will be able to be treated at Baptist Hospital, South Miami Hospital, Doctors Hospital, West Kendall Baptist Hospital, and the Miami Cardiac & Vascular Institute, effective Jan. 1.
While Baptist Hospital’s Miami Cancer Institute is part of the Leon plan, the doctors at the Institute are not included in the Leon network, said a Baptist spokesperson.
Open enrollment for Medicare beneficiaries started Monday and runs through Dec. 7. In 2018, there were 44 million Medicare beneficiaries — or 15 percent of the U.S. population. In Florida, there are more than 4.3 million, according to the Centers for Medicare and Medicaid Services.
The Baptist partnership “has been a milestone for us,” said Benjamin Leon Jr., founder and chairman of Leon Medical Centers, which has been operating in Miami-Dade since 1996.
Brian Keeley, president and chief executive of Baptist Health, said the partnership will help seniors in deciding which Medicare Advantage works for them.
“Each year, as patients review their options for Medicare Advantage plans during open enrollment, the choices of physicians and hospitals included in the various plans become a determining factor in their selection,’’ Keeley noted.
The doctors who are affiliated with Baptist but maintain their private practices will decide individually whether they will be part of the plan.
Medicare Advantage plans, also known as Part C, are offered by insurance companies as an alternative to traditional Medicare. About 20 million seniors nationwide are enrolled in Medicare Advantage plans; Florida has more than 40 percent of Medicare beneficiaries enrolled in these plans, according to the Kaiser Family Foundation.
Medicare Advantage plans include both HMOs and Preferred Provider Organizations (PPOs). Under an HMO, the insurance company contracts with hospitals, skilled nursing facilities, rehabilitation facilities and doctors; members can go only to those who are listed on the plan.
Prior to the partnership between Leon and Baptist, Leon members could go to Jackson Memorial Hospital, Mount Sinai Medical Center, the University of Miami Health System, and the four Tenet hospitals in Miami-Dade: Coral Gables Hospital, Hialeah Hospital, North Shore Medical Center, and Palmetto General.
Those hospitals will still be part of the Leon plan, said Roymi Membiela, Leon’s vice president and chief consumer officer. Leon members will be able to choose between these facilities and Baptist.
Leon operates seven medical centers in Miami-Dade County, in Miami, Westchester, East and West Hialeah, Kendall, and the West Flagler and West Bird Road areas.
This story was originally published October 15, 2018 at 7:46 PM.