Medicare Advantage Plans in North America

Medicare Advantage is Medicare program that serves as a substitute for Original Medicare. Private organizations provide Medicare Advantage Plans. The plans, sometimes referred to as Part C, are offered under Health Maintenance Organization (HMO) or Preferred Provider Organization (PPO). Unlike in Original Medicare where the government settles the benefits, Medicare Advantage Plans are paid for by the Medicare through the private companies.

Medicare benefits constitute parts that are offered by different Medicare Plans. Part A covers for in-patient medical services. However, it does not include services from surgeons and physicians. They are part of Part B of the Medicare benefits, which also covers outpatient hospital services such as diagnostics tests and X-ray.

Original Medicare constitute of Parts A and B. Most of the Medicare Advantage Plans, as sometimes may be referred to as Part C, extend the covers to Part D. The part of the Medicare includes the prescription drug benefit plan. These plans that have Part D are known as Medicare Advantage Prescription Drug Plan (MAPD). It is worth noting that Medicare makes separate payments to MAPD.

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InnovaCare Health is a leading Medicare Advantage provider in North America. Both PMC and MMM plans have over 230,000 in membership. There are over 7,500 service providers who serve the members of InnovaCare Health. PMC and MMM are among the fastest growing health plans in U.S. In 2011, they earned accreditation from National Committee for Quality Assurance (NCQA) in Puerto Rico. MMM is the first Medicare Advantage Plan to be offered in Puerto Rico, and both plans have gained an excellent reputation with CMS granting each plan a four-star rating. InnovaCare depicted success in outcomes, expectations, and patient experience.

InnovaCare Health Leadership

Dr. Rick Shinto heads InnovaCare, who is the President and Chief Executive Officer. He previously served as the CEO of Aveta Inc. from 2008. Avent Inc. was later sold in 2012. With 20 years of clinical experience in managed health care, Dr. Shinto was the Chief Medical Officer of NAMM California before taking over as the President of Aveta Inc. Before joining NAMM, he served as Chief Medical Officer and Chief Operating Officer in Medical Pathways Management Company.

The Chief Administrative Officer, Penelope Kokkinides acceded to the organization in June 2015. She was previously the Chief Operating Officer of InnovaCare Inc. She also acted as the Chief Operating Officer at Aveta Inc. before the selling out of the company and Vice President of Clinical Operations as well.

Penelope has more than 20 years of experience in government health care programs. She is a bachelor’s degree in biological sciences and classical languages graduate from Binghamton University. Penelope two masters degrees in social work and public health from New York University and Columbia University School of Public Health respectively.

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1 thought on “Medicare Advantage Plans in North America”

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