The Wall Street Journal reports that Cigna is planning to sell its Medicare Advantage book of business. For nearly $4 billion, why not? While Cigna is a big health insurer, it has the smallest Medicare Advantage footprint of the big insurers. The sale signals the inevitable future of Medicare Advantage–one or two mega insurers with the vast majority of the Medicare Advantage business and all the power to undermine access to care in order to maximize profits.
Currently, Cigna operates in 29 states. A sale to Blue Cross Blue Shield would boost its power in the Medicare Advantage marketplace. Originally, Cigna had considered buying Humana’s Medicare Advantage book of business, but investors did not receive that plan favorably.
Cigna is a relatively small Medicare Advantage player with only 599,000 Medicare Advantage enrollees as of September 2023. UnitedHealth has more than twelve times as many enrollees, 7.6 million. Humana has nearly 10 times as many enrollees, 5.9 million.
Cigna’s departure from the Medicare Advantage marketplace will be unsettling for its enrollees, but should not come as a surprise. Nothing about a Medicare Advantage plan is reliable. Medicare Advantage management, along with coverage and payment practices, can change all the time. Plans can grow larger through acquisitions or shrink in size.
Medicare Advantage provider networks also are ever-changing and unreliable. Denial rates and prior authorization rules are not even knowable and according to the Office of the Inspector General, there are widespread and persistent inappropriate delays and denials of care and coverage in some Medicare Advantage plans.
Hospitals and specialists are increasingly canceling their Medicare Advantage contracts, meaning unreliable access to care for tens of thousands of Medicare Advantage enrollees. But, these providers are canceling in part because of patient safety concerns, meaning risks to health and well-being in Medicare Advantage. The AMA’s doctors report serious concerns with MA prior authorization, to the detriment of patients.
The Medicare Advantage Open Enrollment period began January 1 and continues through March 31. If you want to be sure you get the care you need when you need it, take advantage of it and switch to Traditional Medicare.
Here’s more from Just Care:
- For-profit hospitals urge CMS to hold Medicare Advantage plans to account for wrongful denials
- Underpayments lead hospitals and specialists to cancel Medicare Advantage contracts
- AHA warns Medicare oversight agency about dangers of Medicare Advantage
- CMS can’t oversee AI denials in Medicare Advantage
- Prior authorization in Medicare Advantage harms patients, sometimes severely
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