Advantage Archives

Anthem Blue Cross and Blue Shield offers Medicare Advantage plans with Essential Extras

October 13, 2020

Anthem Blue Cross and Blue Shield is committed to offering health and wellness services people need to be, and stay, healthy.

MISSOURI, USA — Medicare Open Enrollment may bring up a lot of questions for you, so Martin Esquivel is here to fill us in on some facts. Martin is the VP of Product Management for Anthem Blue Cross and Blue Shield.

Martin explains that original Medicare, or Medicare Part A and Part B, is Medicare Health Insurance available through the Federal government. Part A helps with items such as hospital costs and Part B helps with items such as Doctor’s office visits and outpatient care.

The Medicare Advantage plan is known as Part C. These are Medicare Health Plans offered by private health companies, such as Anthem Blue Cross and Blue Shield. They also might offer additional benefits such as dental, vision, hearing, and preventative services.

Martin says that

Alignment Healthcare Adds MemorialCare Hospitals and Doctors to 2021 Medicare Advantage Provider Network

October 12, 2020

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Nationally ranked nonprofit health system and Medicare Advantage insurance provider sign agreement to expand access to care for Medicare-eligible beneficiaries in Southern California

MemorialCare, a leading nonprofit health system in Southern California with hundreds of primary care and specialty providers, four top hospitals and 200 locations, is joining Alignment Healthcare’s Medicare Advantage provider network starting Jan. 1, 2021, expanding its scope of coverage to 2 million Medicare-eligible residents in Los Angeles and Orange counties.¹

This means that Medicare beneficiaries who enroll in select plans from Alignment – named one of four 2020 Best Insurance Companies for Medicare Advantage in California by U.S. News & World Report – will have access to MemorialCare’s hospitals, health centers and urgent care locations and may seek “in-network” care from physicians associated with MemorialCare Medical Foundation. Medicare’s annual enrollment period for the 2021 plan year begins Oct. 15.

“As part of Alignment’s network, we

The Best Time to Switch From a Medicare Advantage Plan to a Medigap Plan

October 11, 2020

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Last of a three-part series.

Medicare’s annual election period runs from Oct. 15 through December 7.

And that’s the best time to switch from a Medicare Advantage plan to a Medigap plan, according to Jae Oh, author of Maximize Your Medicare.

According to Oh, it’s critical that your Medigap carrier your application before you switch out of your Medicare Advantage and sign up for a standalone Part D plan. The worst outcome, he says, would be to have your Medigap application denied and choose a Part D plan. That would “eject” the Medicare Advantage plan that you may have in place and leave you without additional health benefits, said Oh.

Watch Oh’s videos on the topics on YouTube. Also read Buying your Medigap policy.

So, why might you switch from a Medicare Advantage plan to a Medigap plan?

There are a few reasons, according to Oh. The annual contracts are

Thousands of local seniors left scrambling as financial woes strike Medicare Advantage plan

October 11, 2020

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A Southern California insurance company’s financial woes are sending thousands of seniors in Santa Clara and San Joaquin counties scrambling for health care coverage amid the ongoing coronavirus pandemic.

More than 10,000 people in the two counties enrolled in Vitality Health Plan’s Medicare Advantage option — insurance that provides expanded Medicare coverage — after it began serving the area in January 2019, attracted by good benefits and promises of inexpensive medication. But for many, the company’s offerings turned out to be too good to be true.

“If my parents were on the plan, I would move them,” said Patricia Salas, president of SBHIS Insurance Services, a company that enrolled elderly residents in Vitality’s supplemental Medicare plan and is now hustling to help them find alternatives.

The main issue is Vitality’s dire financial situation. The company is required to maintain what’s called tangible net equity — basically a few million dollars

CarePlus Health Plans Medicare Advantage Plan Achieves 5-Stars Third Year in a Row

October 10, 2020

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It’s the third year in a row, and the fourth time overall, that the company achieves the highest possible rating from the Centers for Medicare & Medicaid Services

MIAMI–(BUSINESS WIRE)–
CarePlus Health Plans, Inc.’s Medicare Advantage members across Florida again can take comfort in knowing that they are enrolled in a health plan that has achieved the highest possible quality rating for the 2021 plan year from the Centers for Medicare & Medicaid Services (CMS). It’s the third year in a row, and the fourth overall, that the company’s Medicare Advantage HMO plan achieved a 5-Star rating. CarePlus is a subsidiary of Humana Inc. (NYSE: HUM).

Bruno Piquin, CarePlus President, attributes the company’s success to its emphasis on creating the best possible member experience.

Orlando area CarePlus member Joan Carucci agrees. “They listen to you. They talk to you, they kid with you, but yet they’re very

HAP Earns Highest Medicare Advantage Star Rating Among All Michigan-based Health Insurers

October 8, 2020

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HAP Earns Highest Medicare Advantage Star Rating Among All Michigan-based Health Insurers

PR Newswire

DETROIT, Oct. 8, 2020

HAP’s 4.5 Stars stand alone among Michigan-based insurers – Top 10% nationally

DETROIT, Oct. 8, 2020 /PRNewswire/ — Health Alliance Plan (HAP), a Michigan-based, nonprofit health plan, is celebrating the only 4.5 Star rating awarded to a Michigan-based insurer. HAP’s Medicare Advantage (MA) HMO earned 4.5 Stars (out of 5) from the Centers for Medicare and Medicaid Services (CMS), ranking HAP’s plan first among Michigan-based insurers and in the top 10% nationally. CMS uses Star Ratings to help consumers make informed decisions about Medicare supplement options, measuring more than 40 performance metrics in five categories. HAP’s Medicare Advantage PPO earned a strong 4.0 rating.

“We have been laser focused on providing competitively priced, high-quality health insurance with an emphasis on customer service,” said Michael Genord, M.D.

CarePartners of Connecticut Introduces Additional Benefits for its Medicare Advantage Members

October 7, 2020

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ROCKY HILL, Conn., Oct. 7, 2020 /PRNewswire/ — CarePartners of Connecticut is providing additional support to older adults across the region as they continue to navigate the COVID-19 pandemic. The health plan is waiving copays for specialist visits, including urgent care, psychiatric and vision service visits, and waiving copays for labs, diagnostics and testing. In addition, it is also expanding its wellness allowance to be used toward the purchase of home exercise equipment. Medicare Advantage members can take advantage of these added benefits beginning Oct. 1 through the remainder of the year.

“The pandemic has changed the way we seek care, with many even forgoing doctor’s office visits in fear of contracting the virus,” said Marla Pantano, president of CarePartners of Connecticut. “We want to ensure our members feel supported by eliminating any barriers to care, and providing added benefits to help with the isolation many of

Medicare Advantage startup Clover Health to go public

October 6, 2020

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Medicare Advantage startup Clover Health is slated to become public through a merger with Social Capital Hedosophia Holdings Corp. III, a special purpose acquisition company, Clover said Tuesday.

The deal values Clover at $3.7 billion. Clover’s management team, including CEO Vivek Garipalli and President Andrew Toy, will continue to lead Clover following the transaction, which is expected to close in the first quarter of 2021.

Chamath Palihapitiya, founder and CEO of Social Capital Hedosophia, will act as a senior advisor to the Clover’s management team. Social Capital Hedosophia is a partnership between investment firms Social Capital and Hedosophia.

The deal is expected to deliver up to $1.2 billion of gross proceeds, including up to $828 million of cash. Clover will receive up to $728 million of the transaction proceeds, and up to $500 million of cash proceeds will be allocated to existing Clover shareholders, according to a news announcement.

Clover,

Clover Health, a Next-Generation Medicare Advantage Insurer, Announces Plans to Become Publicly-traded via Merger with Social Capital Hedosophia

October 6, 2020

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Clover is a next-generation Medicare Advantage insurance company offering best-in-class plans that combine wide access to healthcare and rich supplemental benefits with low out-of-pocket expenses
A unique model in health insurance, Clover partners with primary care physicians using its software platform, the Clover Assistant, to deliver data-driven, personalized insights at the point of care
The transaction is expected to fuel Clover’s trajectory as one of the nation’s fastest growing Medicare Advantage plans
Transaction values Clover at an enterprise value of $3.7 billion and is expected to provide up to $1.2 billion in cash proceeds, including a fully committed PIPE of $400 million and up to $828 million of cash held in the trust account of Social Capital Hedosophia Holdings Corp. III (“SCH”)
PIPE led by $100 million from Chamath Palihapitiya, Founder and CEO of SCH, and $50 million from Hedosophia, as well as commitments from Fidelity Management & Research Company,

Health Insurers Lay Groundwork For Biden And Medicare Advantage At 60

October 4, 2020

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Joe Biden Travels To Michigan To Campaign For President — Democratic presidential nominee Joe Biden delivers remarks in the parking lot of the United Food and … [+] Commercial Workers International Union Local 951 while campaigning October 02, 2020 in Grand Rapids, Michigan. Biden said he tested negative twice Friday for the coronavirus after it was reported that U.S. President Donald Trump and first lady Melania Trump tested positive for COVID-19. (Photo by Chip Somodevilla/Getty Images)

Getty Images

Health insurance companies are expanding Medicare Advantage health plan offerings to seniors in hundreds of new counties for 2021 as new regulations allow for new benefits and the program becomes more popular.

But these health plans could also be establishing a beachhead for perhaps an even bigger draw of seniors if a Joe Biden White House successfully convinces Congress to lower the eligibility of Medicare to 60.

As the presidential campaign heats up in its final month, Biden is stepping up talk

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Tag: Advantage

Anthem Blue Cross and Blue Shield offers Medicare Advantage plans with Essential Extras

Alignment Healthcare Adds MemorialCare Hospitals and Doctors to 2021 Medicare Advantage Provider Network

The Best Time to Switch From a Medicare Advantage Plan to a Medigap Plan

Thousands of local seniors left scrambling as financial woes strike Medicare Advantage plan

CarePlus Health Plans Medicare Advantage Plan Achieves 5-Stars Third Year in a Row

HAP Earns Highest Medicare Advantage Star Rating Among All Michigan-based Health Insurers

CarePartners of Connecticut Introduces Additional Benefits for its Medicare Advantage Members

Medicare Advantage startup Clover Health to go public

Health Insurers Lay Groundwork For Biden And Medicare Advantage At 60