Medicare Advantage Plans Scaling Back

[somarco]

For its part, Humana — whose 6.2 million Medicare Advantage members represent 38% of its total medical members — is getting rid of plans that currently cover about 560,000 members. The company, the second-largest provider of Medicare Advantage plans, said it expects roughly half of them to choose different Humana Medicare plans.

CVS Health similarly said it plans to offload up to 10% of its Medicare Advantage membership to make more profit.

UnitedHealth is in a different position than its competitors in that a sizable portion of its revenue comes from 90,000 employed and affiliated physicians who provide medical care. A STAT investigation detailed the ways the company pressures those doctors to make its Medicare Advantage members appear sicker than they are to get bigger payments from the government.

Insurers went all-in on Medicare Advantage. Now, some are scaling back

Companies like Humana and CVS are adjusting their 2025 plans with an eye toward ditching Medicare members.

www.statnews.com

 

[Chazm]

Thankfully in Florida, humana looks nearly identical in 2025. Uhc dropped their $1k dental to preventive only. But otherwise pretty much the same.
I can’t see those clients moving. I wish I could say the same to my Florida Blue and Aetna clients. Wonder why they aren’t mentioned?

 

[somarco]

AETNA is listed as CVS Health and will offload 10% of their policyholders. More detail in the link.

FB is a small player on a national scale, but they do mention Centene (with 1M policyholders) discontinuing their MA plans for 2025.

 

[Evan]

Thankfully in Florida, humana looks nearly identical in 2025. Uhc dropped their $1k dental to preventive only. But otherwise pretty much the same.
I can’t see those clients moving. I wish I could say the same to my Florida Blue and Aetna clients. Wonder why they aren’t mentioned?

UHC nuked the PPO in Dade and Broward Counties so having to move those clients..

 

[somarco]

UHC nuked the PPO in Dade and Broward Counties

Not real surprising, especially if they offer/will offer an HMO version.

South FL was traditionally an HMO market for years. PPO plans had trouble making a profit there allowing the HMO to dominate.

AVMED was a major player there in the 90's and may still be active.

The HMO model gives carriers more ways to control care and deny non-par claims.

 

[adjusterjack]

For its part, Humana — whose 6.2 million Medicare Advantage members represent 38% of its total medical members — is getting rid of plans that currently cover about 560,000 members. The company, the second-largest provider of Medicare Advantage plans, said it expects roughly half of them to choose different Humana Medicare plans.

How will that work for us who have Humana Medicare Advantage? Will we get a non-renewal letter? If so, when?

 

[Chazm]

UHC nuked the PPO in Dade and Broward Counties so having to move those clients..

I don’t have any clients in those counties but good to know.