Aetna/Coventry 2016 First Look

Jul 10, 2015

  1. FLM2
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    Their plans in Florida are taking a big step back next year-HMO in Lee County has a premium, no more HMO in Palm Beach and others(only Coventry with the lesser network). HMO MOOPs are going up as well (from $5K to $6K in Sarasota/Manatee)-the same plan had a $3400 MOOP a few years ago.

    PPO plan, with $6700 MOOP, is going from $35 to $49, it's to the point where the HDF is a better option for my clients on that plan.

    I can only imagine what the combined Aetna/Coventry/Humana plans will look like in a few years if the merger goes through, it's most likely going to be ugly.
     
  2. vic120
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    I haven't really taken the time to look yet. But I assume the advantage of owning both ends The better network and the economy version is you can control the market and increase the value of the higher option.
     
  3. sman
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    The HMO in Atlanta (only 5 counties - and if you know anything about Georgia you know we have 159 counties - granted, there is a large population in those 5 counties) is staying at zero premium. The PPO (Coventry) is going from $19 to $34 (last year it was a zero premium plan) and the HMO-POS plan is increasing from zero to $59 per month.

    It's not looking like I'll have Front Runner status with Aetna next year. Probably going to be busy moving many of my Coventry clients to other plans. Assuming of course there is a competitive carrier to move them to. If not, they will have to bite the bullet and pay more or even move to a Med Supp.
     
  4. MedicareAgent
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    These plans SUCK. Not sure what the game plan is now, I'm having Aetna seminars, 27 of them lol. Might have to rethink this plan.
    Maybe UHC came out shining this year, who knows.
     
  5. FLM2
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    UHC's network is never coming back to where it was, those days are over.

    Blue never stops taking benefits away so they aren't going to be any better than this year and their PPO is a disgrace (30% coinsurance for outpatient surgery).

    Humana might be a temporary (1-2 years) stop gap but once Aetna gets them the same thing will happen as the rest of their plans.

    Not many other choices in most parts of Florida...
     
  6. MedicareAgent
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    True that UHC won't be back to where it was a few years back but, if they still have a zero plan rppo that is going to be the ticket in Sarasota/Bradenton/Charlotte counties of Florida.

    Humana has a ppo but the hospital copay is ridiculous.
     
  7. Midlevel
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    They say they want to be a leader in the MA market but are only in 744 counties Nationwide the training says. Was really hoping they would expand some, I like working with them better than UH. On the bright side the Coventry/Aetna training was a breeze and was done how it should be done. Just let AHIP take care of the basics and have the training for Coventry/Aetna just be more plan specific.
     
  8. FLM2
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    UHC's RPPO has 20% coinsurance for outpatient surgery and hospital stays where you are under observation-these out of pocket expenses can be really large so I avoid that plan unless it is the only available plan for the client due to provider access.
     
  9. Fisher
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    How can it be higher than original Medicare?
     
  10. sman
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    Because carriers don't have to have the exact same benefits as Medicare. Just a plan that offers a similar out of pocket experience for someone on Medicare alone and that covers the same services as Medicare.
     
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