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.

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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.

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