Here are the numbers for Medicare Advantage enrollment in Pima County, Arizona as of January 2018.
Each year at this time, I look at Medicare Advantage enrollment numbers from the previous year and compare them to the January or February numbers. This shows which plans are gaining enrollments and which ones are losing.
Explanation of Medicare Advantage enrollment in Pima County
MEDISUN is the Blue Cross Blue Shield of Arizona Advantage plan. Its contract number with CMS (Medicare) is H0302 and their enrollment numbers are down 14%.
1,702 people jumped ship during the Annual Enrollment Period (October 15 – December 7). They most likely moved to another Advantage plan because BCBS raised co-pays in their plan and introduced a deductible in the drug coverage.
According to plan representatives who train brokers, the changes are due to the plan’s 3.5 star rating by CMS (Medicare). If a plan gets 4 stars for high marks on customer service and a long list of other factors, CMS awards the company bonus money. Because BCBS did not get the extra money for 2018, they had to change their benefits.
PACIFICARE OF COLORADO is actually the AARP Medicare Complete HMO by UnitedHealthcare (contract number H0609). This plan keeps gaining enrollment as other plans falter.
So why is an Arizona plan under a Colorado contract? Apparently, the Colorado plan gets 4 stars, so United changed the contract numbers for the Arizona plan – and voila!…. the Pima County plan gets more money from CMS.
UNITEDHEALTHCARE OF WISCONSIN is actually the AARP Medicare Complete HMO-POS. I’m surprised to see this plan gaining enrollment as it has a $12 monthly premium and a $225 deductible in the drug coverage. The one big difference with this “HMO-POS” plan is that is does not require referrals to see a specialist. Some people hate the idea of referrals, which most HMO plans require. I guess some people are willing to pay for that benefit.
CAREMORE HEALTH PLAN OF ARIZONA has not lost or gained many members over the last few years. Caremore has “special needs plans” for people with diabetes, heart disease, and pulmonary conditions.
HUMANA picked up enrollments during the Annual Enrollment Period for its HMO plan, gaining 8%.
HEALTH NET’s new HMO plan, called Allwell Premier, (H9287) picked up 1,162 members during AEP – although, it is likely the company got these enrollments by people moving from it older plans (under contract H0351) to the Premier plan.
CIGNA enrollment is up 14% after AEP. That’s good news after Cigna Medicare Advantage plans across the country spent most of 2017 under sanction from CMS (Medicare) due to issues with customer service and Cigna drug plans. Interesting that Cigna gets a 4-star rating after being suspended from enrolling new members for over one year.
AETNA came to Pima County for 2018 and must be disappointed to have enrolled only 78 people in its HMO plan (H3931). For a new plan to the Tucson-area market, it just wasn’t competitive with its co-pays and other costs. The AETNA PPO plan (H5521) fared better, enrolling 237 new members during AEP. A PPO plan allows people to go out of network and that is appealing to people who spend time in other parts of the country.
STAR RATINGS: Some people look at the star ratings when evaluating Medicare Advantage plans. In my opinion, the ratings are not very useful when big companies can play games with their contracts and lobby Medicare for a higher rating.
The Medicare Advantage enrollment numbers come from the CMS website and can be found here:
To see past posts on Medicare Advantage enrollment in Pima County, check out these links:
March 2017 numbers:
February of 2015 numbers after a tumultuous Annual Enrollment Period.