If you depend on Humana for your Medicare Advantage plan, you might need to prepare for a change. Humana, one of the largest companies offering Medicare Advantage plans, has recently spoken of its plan to stop its services in 13 different markets across the United States which will affect around 560,000 people. This development may leave nearly 500,000 people in America looking for different plans for 2025. But what could have led to such a decision?
Humana’s Chief Financial Officer, Susan Diamond, explained that the decision was made because of unprofitable revenue performance in those regions. The company is emphasizing on concentrating on areas with good profit potentials and is severing ties with unprofitable regions.
Which States are affected?
Although the precise 13 counties or regions that will be exited by Humana Inc. have not been made public, it is possible that the people affected will be spread across different states in the U.S. Primarily, those individuals enrolled in Medicare Advantage plans, a lot of whom may have to later look for other forms of coverage. Although other insurance companies may fill the void, the disruption could be highly pronounced especially for rural populations where the variety of Medicare Advantage plans available is quite thin.
In case you are concerned as to whether your locality will be affected, it is wise to call Humana or use the Medicare plan finder before making any assumptions. The insurer is looking to communicate this information to enrollees who are affected so that they will switch to another alternative by 2025.
What are medicare advantage plans?
Medicare Advantage (also known as Medicare Part C) is an alternative to traditional Medicare, offering more comprehensive benefits through private insurance companies like Humana. These plans typically include extra coverage, such as vision, dental, and prescription drugs, which aren’t covered under Original Medicare. However, since Medicare Advantage plans are run by private insurers, they are subject to market fluctuations and can change drastically from year to year, as is the case with Humana’s recent announcement.
If you have a Medicare Advantage plan with Humana, you will likely need to find a new provider or switch to Original Medicare. Fortunately, most areas will still offer other Medicare Advantage plans, but the coverage options and costs may differ.
How will this affect you?
While losing your current plan might feel stressful, Humana assures that other options will be available for most affected individuals. “Almost all of those members have other options,” Susan Diamond said during a conference. And Louise Norris, a health policy analyst, added in a statement to Newsweek, “Even in areas where Humana pulls out, other Medicare Advantage plans should still be available.”
However, it’s essential to do your research. Premiums, deductibles, and co-pays may increase with your new plan, and the benefits might not align with what you’re used to. Now is a good time to start preparing, so you won’t be caught off guard during the open enrollment period. Make sure to reach out to brokers, Medicare advisers, or even Humana’s call center, as they’ll be equipped with additional staff to help answer questions from concerned policyholders like you.
Why is Humana making this change?
This move isn’t entirely unprecedented. Several insurance companies have begun reevaluating their Medicare Advantage offerings after the Centers for Medicare and Medicaid Services (CMS) reduced benchmark rates, leading to lower profit margins. Humana’s focus on staying profitable means it had to make tough choices, including exiting underperforming markets. While the company expects a temporary loss of enrollees, it believes focusing on core, profitable regions will better position them for long-term stability.
In short, while the news may seem alarming, most of the half a million affected Americans should still have coverage options available.
