Open Enrollment – The Medicare Advantage Rush is on!

MA plans are adding enticements to attract new beneficiaries.

Open enrollment for federal healthcare plans starts on Oct. 15, and that can only mean one thing: every Medicare Advantage (MA) plan is sharing their enhancements to entice prospective beneficiaries.

Amid the COVID-19 pandemic, these plans grew in number, with benefits equally expanding. Yet just when we thought we had seen it all, wait…there’s more! Aetna, Centene, Cigna, Humana, and UnitedHealth Group all announced big news last week that is worthy of sharing.

Medicare Advantage enrollment has been steadily rising; it is projected to add more than 3 million beneficiaries this year, rising to 29.5 million total in 2022. A big part of this growth is being spurred by UnitedHealthcare, which will solidify its top position in the MA product space, adding close to 3.1 million members.

Centene is also increasing their MA product footprint by 26 percent. Some might recall that in September, Centene announced consolidation of its current Medicare brands to form Wellcare. The result is that more than 48 million beneficiaries in 36 states will have access to expanding MA programs.

Cigna is keeping its party going, growing plans by 30 percent, especially across Connecticut, Oregon, and Washington State. The insurer currently offers plans in 477 counties in 26 states, plus Washington, D.C. Humana grew its MA population by close to 5 million people, over 12 percent from last year; they will add over 70 new health plans with prescription drug and other special needs offerings, including access to telehealth for primary care, urgent care, and outpatient behavioral health needs, with no copay. In addition, those who have contracted coronavirus can receive testing, treatment, vaccinations, and 28 meal deliveries with no copay. UnitedHealthcare will institute a “UCard” to be leveraged for over-the-counter benefits and healthy food benefit cards. Members can also use the cards to redeem rewards at retail locations and online.

Now, premiums are expected to drop slightly, but don’t be fooled by that metric. While the average premium for Medicare Advantage plans will decrease from $21.22 to $19 per month, Part D coverage will rise, from $31.47 to $33 per month; the Part D rise will wipe out any anticipated profits from the premium decreases. Oh well!

Yet amid the growth of these plans, there is increased scrutiny, and meeting of the medical loss ratio. Plans must still spend a minimum of 85 percent of premium dollars on medical expenses, and many struggle with that goal. Three UnitedHealthcare plans and one Anthem plan missed that mark for three years, and are now subject to major sanctions, per the requirements (with more sanctions expected to follow).

Our Monitor Mondays survey this week asked our listeners how their composition of Medicare Advantage beneficiaries has shifted this year; answers appear here.

Print Friendly, PDF & Email
Facebook
Twitter
LinkedIn

Ellen Fink-Samnick, MSW, ACSW, LCSW, CCM, CRP

Ellen Fink-Samnick is an award-winning healthcare industry expert. She is the esteemed author of books, articles, white papers, and knowledge products. A subject matter expert on the Social Determinants of Health, her latest books, The Essential Guide to Interprofessional Ethics for Healthcare Case Management and Social Determinants of Health: Case Management’s Next Frontier (with foreword by Dr. Ronald Hirsch), are published through HCPro. She is a panelist on Monitor Mondays, frequent contributor to Talk Ten Tuesdays, and member of the RACmonitor Editorial Board.

Related Stories

Remain Compliant – and Take the Money

Remain Compliant – and Take the Money

Our first topic today is local coverage determinations (LCDs) and variation. I have written in the past about national and local coverage determinations, and I

Read More

Leave a Reply

Please log in to your account to comment on this article.

Featured Webcasts

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Leveraging the CERT: A New Coding and Billing Risk Assessment Plan

Frank Cohen shows you how to leverage the Comprehensive Error Rate Testing Program (CERT) to create your own internal coding and billing risk assessment plan, including granular identification of risk areas and prioritizing audit tasks and functions resulting in decreased claim submission errors, reduced risk of audit-related damages, and a smoother, more efficient reimbursement process from Medicare.

April 9, 2024
2024 Observation Services Billing: How to Get It Right

2024 Observation Services Billing: How to Get It Right

Dr. Ronald Hirsch presents an essential “A to Z” review of Observation, including proper use for Medicare, Medicare Advantage, and commercial payers. He addresses the correct use of Observation in medical patients and surgical patients, and how to deal with the billing of unnecessary Observation services, professional fee billing, and more.

March 21, 2024
Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets

Explore the top-10 federal audit targets for 2024 in our webcast, “Top-10 Compliance Risk Areas for Hospitals & Physicians in 2024: Get Ahead of Federal Audit Targets,” featuring Certified Compliance Officer Michael G. Calahan, PA, MBA. Gain insights and best practices to proactively address risks, enhance compliance, and ensure financial well-being for your healthcare facility or practice. Join us for a comprehensive guide to successfully navigating the federal audit landscape.

February 22, 2024
Mastering Healthcare Refunds: Navigating Compliance with Confidence

Mastering Healthcare Refunds: Navigating Compliance with Confidence

Join healthcare attorney David Glaser, as he debunks refund myths, clarifies compliance essentials, and empowers healthcare professionals to safeguard facility finances. Uncover the secrets behind when to refund and why it matters. Don’t miss this crucial insight into strategic refund management.

February 29, 2024
2024 SDoH Update: Navigating Coding and Screening Assessment

2024 SDoH Update: Navigating Coding and Screening Assessment

Dive deep into the world of Social Determinants of Health (SDoH) coding with our comprehensive webcast. Explore the latest OPPS codes for 2024, understand SDoH assessments, and discover effective strategies for integrating coding seamlessly into healthcare practices. Gain invaluable insights and practical knowledge to navigate the complexities of SDoH coding confidently. Join us to unlock the potential of coding in promoting holistic patient care.

May 22, 2024
2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

2024 ICD-10-CM/PCS Coding Clinic Update Webcast Series

HIM coding expert, Kay Piper, RHIA, CDIP, CCS, reviews the guidance and updates coders and CDIs on important information in each of the AHA’s 2024 ICD-10-CM/PCS Quarterly Coding Clinics in easy-to-access on-demand webcasts, available shortly after each official publication.

April 15, 2024

Trending News

Happy National Doctor’s Day! Learn how to get a complimentary webcast on ‘Decoding Social Admissions’ as a token of our heartfelt appreciation! Click here to learn more →

Happy World Health Day! Our exclusive webcast, ‘2024 SDoH Update: Navigating Coding and Screening Assessment,’  is just $99 for a limited time! Use code WorldHealth24 at checkout.

SPRING INTO SAVINGS! Get 21% OFF during our exclusive two-day sale starting 3/21/2024. Use SPRING24 at checkout to claim this offer. Click here to learn more →