{"id":13077,"date":"2024-09-22T11:39:22","date_gmt":"2024-09-22T11:39:22","guid":{"rendered":"https:\/\/distilinfo.com\/healthplan\/?p=13077"},"modified":"2024-09-22T11:39:22","modified_gmt":"2024-09-22T11:39:22","slug":"cigna-enhances-medicare-advantage","status":"publish","type":"post","link":"https:\/\/distilinfo.com\/healthplan\/cigna-enhances-medicare-advantage\/","title":{"rendered":"Cigna Enhances Medicare Advantage Options Across Eight States"},"content":{"rendered":"\r\n<div id=\"rank-math-toc\" class=\"wp-block-rank-math-toc-block has-pale-ocean-gradient-background has-background\"><nav>\r\n<ul>\r\n<li><a href=\"#cignas-medicare-advantage-plan-reductions\">Cigna&#8217;s Medicare Advantage Plan Reductions<\/a>\r\n<ul>\r\n<li><a href=\"#states-affected\">States Affected<\/a><\/li>\r\n<li><a href=\"#impact-on-beneficiaries\">Impact on Beneficiaries<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#reasons-for-the-plan-adjustments\">Reasons for the Plan Adjustments<\/a>\r\n<ul>\r\n<li><a href=\"#viability-and-network-adequacy\">Viability and Network Adequacy<\/a><\/li>\r\n<li><a href=\"#provider-engagement\">Provider Engagement<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#cignas-partnership-with-health-care-service-corp-hcsc\">Cigna&#8217;s Partnership with Health Care Service Corp (HCSC)<\/a>\r\n<ul>\r\n<li><a href=\"#the-3-7-billion-deal\">The $3.7 Billion Deal<\/a><\/li>\r\n<li><a href=\"#evernorths-role-in-pharmacy-services\">Evernorth&#8217;s Role in Pharmacy Services<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#market-wide-implications\">Market-Wide Implications<\/a>\r\n<ul>\r\n<li><a href=\"#humanas-market-exit\">Humana&#8217;s Market Exit<\/a><\/li>\r\n<li><a href=\"#the-impact-of-regulatory-changes\">The Impact of Regulatory Changes<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#alternatives-for-affected-members\">Alternatives for Affected Members<\/a><\/li>\r\n<li><a href=\"#frequently-asked-questions-fa-qs\">Frequently Asked Questions (FAQs)<\/a>\r\n<ul>\r\n<li><a href=\"#1-which-states-are-most-impacted-by-cignas-plan-reductions\">1. Which states are most impacted by Cigna&#8217;s plan reductions?<\/a><\/li>\r\n<li><a href=\"#2-will-all-beneficiaries-lose-their-coverage\">2. Will all beneficiaries lose their coverage?<\/a><\/li>\r\n<li><a href=\"#3-how-will-this-impact-my-pharmacy-services\">3. How will this impact my pharmacy services?<\/a><\/li>\r\n<\/ul>\r\n<\/li>\r\n<li><a href=\"#conclusion\">Conclusion<\/a><\/li>\r\n<\/ul>\r\n<\/nav><\/div>\r\n\r\n\r\n\r\n\r\n\r\n<p>Cigna, one of the largest health insurance providers in the U.S., is reshaping its Medicare Advantage (MA) offerings by reducing its coverage across eight states. The changes, which will impact <a href=\"https:\/\/finance.yahoo.com\/news\/cigna-scaling-back-medicare-advantage-092505187.html\" target=\"_blank\" rel=\"noopener\">36 health plans<\/a>, are part of its&#8217;s effort to optimize its Medicare Advantage services, ensuring viability, network adequacy, and enhanced provider engagement. This article will explore the details of it&#8217;s decision, the states affected, and the impact on Medicare beneficiaries.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"cignas-medicare-advantage-plan-reductions\" class=\"wp-block-heading\">Cigna&#8217;s Medicare Advantage Plan Reductions<\/h3>\r\n\r\n\r\n\r\n<p>Cigna\u2019s decision to reduce the number of Medicare Advantage plans is poised to affect several states and thousands of beneficiaries. While 36 plans are set to be impacted, most have relatively low enrollment, which may minimize the disruption for beneficiaries. However, certain counties will see a complete exit from Cigna&#8217;s MA services, leaving many residents searching for new plan alternatives.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"states-affected\" class=\"wp-block-heading\">States Affected<\/h4>\r\n\r\n\r\n\r\n<p>The eight states affected by Cigna\u2019s Medicare Advantage restructuring are:<\/p>\r\n\r\n\r\n\r\n<p>1. Colorado<br \/>2. Florida<br \/>3. Illinois<br \/>4. Missouri<br \/>5. North Carolina<br \/>6. Tennessee<br \/>7. Texas<br \/>8. Utah<\/p>\r\n\r\n\r\n\r\n<p>Florida is expected to be the most affected, with up to 4,000 of the 5,395 beneficiaries impacted residing in the state. Cigna\u2019s membership in Florida will see significant reductions, particularly in PPO (Preferred Provider Organization) plans, which will no longer be offered in the state and some counties in two other states.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"impact-on-beneficiaries\" class=\"wp-block-heading\">Impact on Beneficiaries<\/h4>\r\n\r\n\r\n\r\n<p>In total, around 5,395 beneficiaries will be affected by the changes, with alternative plans available in most areas except for select counties in Missouri and North Carolina, where it is fully exiting the market. These members will need to find new Medicare Advantage plans to maintain their healthcare coverage in 2025.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"reasons-for-the-plan-adjustments\" class=\"wp-block-heading\">Reasons for the Plan Adjustments<\/h3>\r\n\r\n\r\n\r\n<p>Cigna Healthcare regularly evaluates its service areas to ensure that the Medicare Advantage plans it offers meet the highest standards of care. Several factors contributed to the decision to reduce plans in these eight states.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"viability-and-network-adequacy\" class=\"wp-block-heading\">Viability and Network Adequacy<\/h4>\r\n\r\n\r\n\r\n<p>One of the main reasons behind it\u2019s decision is the evaluation of service areas for long-term viability. When certain regions show signs of underperformance, such as low enrollment or gaps in the provider network, Cigna may choose to withdraw its Medicare Advantage offerings.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"provider-engagement\" class=\"wp-block-heading\">Provider Engagement<\/h4>\r\n\r\n\r\n\r\n<p>Cigna also places a strong emphasis on provider engagement. If gaps are identified between healthcare providers and the network, and these issues cannot be resolved, Cigna opts to withdraw its plans rather than offering suboptimal services to its members.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"cignas-partnership-with-health-care-service-corp-hcsc\" class=\"wp-block-heading\">Cigna&#8217;s Partnership with Health Care Service Corp (HCSC)<\/h3>\r\n\r\n\r\n\r\n<p>In January 2024, Cigna entered into a significant $3.7 billion agreement with <a href=\"https:\/\/www.hcsc.com\/newsroom\/news-releases\/2024\/agreement-acquire-cigna-medicare-careallies-businesses\" target=\"_blank\" rel=\"noopener\">Health Care Service Corp (HCSC)<\/a> to sell its Medicare business. This sale included a broad portfolio of Medicare services, including Medicare Advantage, Part D plans, supplemental benefits, and the CareAllies business.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"the-3-7-billion-deal\" class=\"wp-block-heading\">The $3.7 Billion Deal<\/h4>\r\n\r\n\r\n\r\n<p>The deal between Cigna and HCSC is expected to reshape both organizations\u2019 Medicare offerings. Cigna\u2019s decision to trim its Medicare Advantage plans aligns with the broader shift towards handing over more responsibility to HCSC.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"evernorths-role-in-pharmacy-services\" class=\"wp-block-heading\">Evernorth&#8217;s Role in Pharmacy Services<\/h4>\r\n\r\n\r\n\r\n<p>As part of the deal, Evernorth, a subsidiary of Cigna, has partnered with HCSC to provide pharmacy services. This collaboration will allow Evernorth to expand its reach and offer enhanced pharmacy services to Medicare beneficiaries under HCSC\u2019s purview.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"market-wide-implications\" class=\"wp-block-heading\">Market-Wide Implications<\/h3>\r\n\r\n\r\n\r\n<p>Cigna isn\u2019t the only major insurer feeling the effects of market and regulatory shifts. The Medicare Advantage space has been under pressure due to regulatory changes and increased utilization.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"humanas-market-exit\" class=\"wp-block-heading\">Humana&#8217;s Market Exit<\/h4>\r\n\r\n\r\n\r\n<p>In response to similar pressures, Humana announced its exit from 13 Medicare Advantage markets in 2025. This move will impact around 10% of Humana\u2019s MA membership base, highlighting the broader challenges that insurers face in managing costs while providing high-quality care.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"the-impact-of-regulatory-changes\" class=\"wp-block-heading\">The Impact of Regulatory Changes<\/h4>\r\n\r\n\r\n\r\n<p>The Medicare Advantage market is heavily regulated, and recent changes have placed additional burdens on insurers. Many health plans have reported high utilization rates in the first half of the year, leading to increased costs and prompting companies like Cigna and Humana to reassess their service offerings.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"alternatives-for-affected-members\" class=\"wp-block-heading\">Alternatives for Affected Members<\/h3>\r\n\r\n\r\n\r\n<p>While Cigna is trimming its Medicare Advantage plans in select counties, the company has emphasized that alternatives are available for most affected beneficiaries. In Florida, for example, other Cigna MA plans will still be available in several counties, and members are encouraged to explore their options during the next open enrollment period.<\/p>\r\n\r\n\r\n\r\n<p>Additionally, Cigna has assured members that they will be contacted with information about alternative coverage options. Those who need assistance navigating these changes can also reach out to licensed insurance agents or use Medicare\u2019s Plan Finder tool to explore other Medicare Advantage plans in their area.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"frequently-asked-questions-fa-qs\" class=\"wp-block-heading\">Frequently Asked Questions (FAQs)<\/h3>\r\n\r\n\r\n\r\n<h4 id=\"1-which-states-are-most-impacted-by-cignas-plan-reductions\" class=\"wp-block-heading\">1. Which states are most impacted by Cigna&#8217;s plan reductions?<\/h4>\r\n\r\n\r\n\r\n<p>A. The states most affected by the plan reductions are Florida, Missouri, and North Carolina, with Florida seeing the largest impact on membership.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"2-will-all-beneficiaries-lose-their-coverage\" class=\"wp-block-heading\">2. Will all beneficiaries lose their coverage?<\/h4>\r\n\r\n\r\n\r\n<p>A. No, while 36 plans are affected, most beneficiaries will have alternative plan options available. However, select counties in Missouri and North Carolina will see full exits, and beneficiaries in these areas will need to find new plans.<\/p>\r\n\r\n\r\n\r\n<h4 id=\"3-how-will-this-impact-my-pharmacy-services\" class=\"wp-block-heading\">3. How will this impact my pharmacy services?<\/h4>\r\n\r\n\r\n\r\n<p>A. Cigna\u2019s subsidiary, Evernorth, will continue to provide pharmacy services in partnership with Health Care Service Corp (HCSC), so there should be minimal disruption to pharmacy benefits.<\/p>\r\n\r\n\r\n\r\n<h3 id=\"conclusion\" class=\"wp-block-heading\">Conclusion<\/h3>\r\n\r\n\r\n\r\n<p>Cigna&#8217;s decision to reduce its Medicare Advantage plan lineup across eight states is part of a broader trend among insurers to reevaluate their offerings in light of regulatory changes and increased utilization. While the reductions will impact over 5,000 beneficiaries, alternatives are available in most areas. Its partnership with Health Care Service Corp and Evernorth will continue to shape the future of its Medicare business, offering new opportunities for enhanced services. Affected members should explore their options during open enrollment and find plans that best meet their healthcare needs.<\/p>\r\n\r\n\r\n\r\n<p><span data-teams=\"true\"><span class=\"ui-provider a b c d e f g h i j k l m n o p q r s t u v w x y z ab ac ae af ag ah ai aj ak\" dir=\"ltr\">Discover the latest <a id=\"menur6k\" class=\"fui-Link ___1q1shib f2hkw1w f3rmtva f1ewtqcl fyind8e f1k6fduh f1w7gpdv fk6fouc fjoy568 figsok6 f1s184ao f1mk8lai fnbmjn9 f1o700av f13mvf36 f1cmlufx f9n3di6 f1ids18y f1tx3yz7 f1deo86v f1eh06m1 f1iescvh fhgqx19 f1olyrje f1p93eir f1nev41a f1h8hb77 f1lqvz6u f10aw75t fsle3fq f17ae5zn\" title=\"https:\/\/distilinfo.com\/healthplan\/\" href=\"https:\/\/distilinfo.com\/healthplan\/\" target=\"_blank\" rel=\"noreferrer noopener\" aria-label=\"Link payers&#039; news updates\"><strong>payers&#8217; news updates<\/strong><\/a> with a single click. 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