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CMS Approves FamilyCare’s Orderly Exit from Medicare on July 1

Portland, Ore. -- May 17, 2018 -- FamilyCare Health Plans’ contract with the Centers for Medicare and Medicaid Services (CMS) will end on July 1, 2018, and FamilyCare will no longer serve Medicare members in Tri-County and Clatsop County. Members will not lose their Medicare coverage and will transition to other Medicare Advantage plans or traditional Medicare.

Since its inception in 1984, FamilyCare has offered both Medicare and Medicaid plans to Oregonians. FamilyCare’s decision to end its contract with CMS comes four months after FamilyCare was forced to close its Medicaid plan, ending the alignment of Medicare and Medicaid coverage and benefits for FamilyCare’s dual eligible members.  Following this change, FamilyCare and CMS agreed that it was in the members’ best interest to end FamilyCare’s Medicare plan on July 1, 2018. 

All members have received information regarding the end of their FamilyCare coverage via U.S. mail. Public and member notifications regarding FamilyCare’s exit from the Medicare market can be viewed here:  https://www.familycareinc.org/medicare/.

What FamilyCare members need to know:

  • All FamilyCare members will continue to have Medicare coverage; no FamilyCare members will lose Medicare coverage as a result of this decision.
  • All FamilyCare members will have until June 30, 2018 to select a new Medicare Advantage plan.
  • Those who do not select a new plan by June 30 will be covered by traditional Medicare starting on July 1, 2018 and will have continuing prescription drug coverage through Envision Insurance Company.
  • Approximately 2,100 non-dual eligible members will have until July 30, 2018 to select a new Medicare Advantage plan while covered by traditional Medicare.
  • Approximately 1,600 dual eligible (Medicaid and Medicare) members can select a new Medicare Advantage plan at any time.
  • For dual eligible members, if their Oregon Health Plan carrier also offers Medicare, members can align their Medicare and Medicaid coverage with the same carrier.


About FamilyCare Health

For more than 30 years, FamilyCare Health provided patient-centered health care to Oregonians. FamilyCare Health was the first health plan in Oregon to integrate models of physical and mental health and the first CCO in the tri‐county area certified by the Oregon Health Authority.

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