Medicare Advantage Enrollment in Tucson and Pima County

In Tucson and Pima County, competition is fierce among the four major players in the Medicare Advantage market. Medicare Advantage is popular among Pima County seniors, with 45% being enrolled in these private plans.

TO SEE THE 2015 MEDICARE ADVANTAGE ENROLLMENT NUMBERS, GO HERE:  https://medicareblog.org/medicare-advantage-tucson-2/

CMS (Centers for Medicare & Medicaid Services) released the latest numbers on Medicare Advantage enrollment, and here’s what it looks like in Pima County. I have not listed every plan, just the ones with the biggest enrollment.  I have not listed PPO plans, which have fairly small enrollment numbers. All of the plans below are HMO plans with a network of providers, though two of these plans have some local out-of-network options.

Feb-12 Feb-11
AARP Medicare Complete 19,980 22,004 -9%
AARP Medicare Complete Plus 14,952 13,282 +13%
HUMANA HMO-pos 4,609 3,613 +28%
HEALTH NET 13,331 13,953 -4%
CAREMORE 8,361 5,678 +47%
SCAN HEALTH PLAN 167 148 +13%

CareMore is only in its third year in Tucson, but its enrollment is growing fast, mostly by getting people to change from other Advantage plans. I can’t go into details here, lest someone think I’m promoting these plans.  I’m just reporting the numbers.

Health Net had over 19,000 member three years ago.  Then they became the first Tucson HMO to charge a premium, which led thousands of their members to move to other plans with $0 premium.

SCAN was supposed to be a new competitor in the Tucson market in 2012, but they seem to have put the brakes on building their provider network here. They say they made a decision to concentrate on their operations in Phoenix where they have 12,688 members and a large network of providers.

AARP Medicare Complete plans are actually UnitedHealthcare plans.  The AARP Medicare Complete is the old Pacificare plan and has been  around for a long time.  The AARP Medicare Complete Plus plan is known to providers as the “United plan” and has a different contract.

The enrollment numbers come from CMS and can be found at https://www.cms.gov/MCRAdvPartDEnrolData/MCESR/list.asp#TopOfPage.

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3 Responses to "Medicare Advantage Enrollment in Tucson and Pima County"

  1. Katharine says:

    I belonged to Caremore for 1 3/4 years.  It was a nightmare, both administratively and medically. I encourage anyone thinking about  joining Caremore to stay away. I switched to AARP UnitedHealthcare and so far am quite satisfied.

  2. Katharine says:

    To clarify, I am no longer a member of ANY Medicare Advantage program.  Instead, I have original Medicare w/ Plan F Supplement, and also have AARP UnitedHealthcare Part D drug coverage. It’s my understanding that, when you enroll in a Medicare Advantage plan, the plan receives a lump sum payment. Because of that, you do not have to pay a monthly premium. However, the plan then has all the motivation in the world to LIMIT the $$ it pays out for  your health care.  So, that becomes their main motivation. Don’t be seduced by not having to pay a monthly premium. You will pay in the form of aggravation and poor quality care.

  3. B rad says:

    But being on Medicare and Plan F you as a consumer have no incentive to be prudent with the governments money that pays claims.  Every visit costs you nothing, so why not go for every hangnail and sniffle.  At least with Medicare Advantage, the private insurers compete and those that satisfy the members will attract more members.  That’s their motivation.  And by managing the fee they receive they ultimately stay profitable.  Free market, baby.

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