Medicare Advantage Enrollment in Tucson

Each year at this time I like to look at Medicare Advantage enrollment in Tucson and which plans added members and which ones lost from one year to the next.

Tucson (Pima County) has lots of competition in the Medicare Advantage market.  Blue Cross Blue Shield of Arizona Advantage was new to Tucson in 2015 and Cigna-HealthSpring was new for 2016.  They both seem to have taken business from plans that have been around for a long time.

During the Annual Enrollment Period (AEP), October 15 – December 7, 2015, people can move to another Advantage plan that takes effect on January 1st.


Here are the numbers from the Medicare website:

Dec-15 Feb-16 CHANGE        %
MEDISUN, INC. (BCBS) 10,048 10,285 237  +2%
PACIFICARE OF ARIZONA, INC. 30,216 31,921 1,705   +6%
UNITEDHEALTHCARE OF AZ  6,156 5545 -611 -10%
HEALTH NET OF ARIZONA, INC.  5,630 5,159 -471  -8%
HUMANA HEALTH PLAN,  INC.  5,427 4,695 -732 -13%
CAREMORE HEALTH PLAN OF AZ  11,097 11,102 5   0%
SCAN  591 0 -591

Blue Cross Blue Shield of Arizona Advantage (Medisun) added to its enrollment numbers – but they would have probably been higher if not for the contract dispute with Carondolet.

I had clients who moved to other Medicare Advantage plans near the end of the AEP because they were told their doctors would no longer be in the BCBS network as of January 1.   Then, on December 30th, BCBS and Carondolet agreed to a contract.

Pacificare is actually the AARP Medicare Complete HMO.  Doctors’ offices call this plan the “Pacificare plan” when asked if they are contracted.  The other United plan is actually the AARP Medicare Complete Plus (HMO-POS) and it is referred to as “the United Plan” by providers.  These two plans have different contracts and slightly different networks.

Health Net continues to lose members.  They had over 20,000 members just a few years ago.

Cigna-HealthSpring was new to the Tucson market for 2016 and did very well by enrolling nearly 2,500 members during the Annual Enrollment Period.  Then they got sanctioned by Medicare and are not allowed to enroll any new members.

The “sanction” was the result of an audit by Medicare that found deficiencies in Cigna’s Part D coverage, its compliance program, and its handling of appeals of coverage decisions.

Cigna went from being a five-star plan that was allowed to enroll new members all year long, to being sanctioned by Medicare. The sanction means Cigna-HealthSpring cannot enroll anyone into their Medicare Advantage plans or Part D plans until they show Medicare they have fixed all their problems.

Humana lost members from its HMO plan.

Caremore membership numbers stayed almost the same.

SCAN closed down its operations in Arizona, forcing nearly 600 people in Tucson to find a new plan for 2016.

Medicare Advantage enrollment numbers can be found here:

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