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Humana has announced it will debut a new Medicare Advantage PPO plan in 37 rural counties in North Carolina, responding to market demand in the eastern part of the state.

The new Medicare option will be available during this year’s Medicare Advantage and Prescription Drug Plan Annual Election Period, or AEP, which runs from Oct. 15 through Dec. 7, for plan coverage taking effect January 1, 2022.

Humana North Carolina Medicare Vice President Kathleen Schwarzwalder said in a statement that the move is a response to the limited health plan options among Medicare-eligible patients in North Carolina’s rural communities. 

The plan, she said, focuses on whole-person healthcare, including dental, hearing and vision, and includes access to all major hospital systems, including via telehealth-enabled virtual medical visits, which she said will make it easier for rural residents to seek out and receive care.

The 37 rural counties where Humana is introducing its Humana Medicare Advantage PPO plan include: Alleghany, Ashe, Beaufort, Bertie, Chowan, Currituck, Duplin, Edgecombe, Franklin, Gates, Granville, Greene, Halifax, Hertford, Hoke, Hyde, Jones, Martin, Montgomery, Nash, Northampton, Pamlico, Pasquotank, Perquimans, Pitt, Richmond, Robeson, Sampson, Scotland, Surry, Tyrrell, Vance, Warren, Washington, Wayne, Wilkes and Wilson.

WHAT’S THE IMPACT

According to Humana, the Medicare PPO offered in these counties provides people with Medicare an affordable alternative to original Medicare only, or original Medicare paired with a Medicare Supplement plan. The plan offers a $0 premium, no or low copays for doctor’s visits, hearing, dental, vision and prescription drug coverage, and $0 copay for virtual office visits for primary care, urgent care and behavioral health.

And for 2022 MA plan members with a COVID-19 diagnosis, there is a $0 copay for testing, treatment, vaccinations and 14 days of home-delivered meals — up to 28 meals of them.

There will also be options for veterans in 2022, with the Humana Honor plan available in every county in North Carolina. While veterans can select from any Medicare Advantage plan available in their area, these plans are designed to complement VA healthcare coverage by covering services at non-VA facilities, including dental coverage. 

Because some veterans may prefer prescription drug coverage through their VA benefits, the Humana Honor plan does not include prescription drug coverage, the insurer said.

Most Humana Medicare Advantage plans also include SilverSneakers, which provides memberships at participating fitness centers; Go365, a wellness and rewards program designed to motivate and reward members for taking steps toward healthy behaviors, like receiving recommended wellness screenings, flu shots and other activities; and Humana Well Dine, which provides meals to eligible Medicare members recovering from an inpatient stay in a hospital or skilled nursing facility.

THE LARGER TREND

Humana is the latest of several insurers set to expand their Medicare Advantage footprint in 2022. Just this week, UnitedHealthcare, which already has significant market control with its MA plans, said it will strengthen its foothold in the space by expanding its MA plans in 2022, adding a potential 3.1 million members and reaching 94% of Medicare-eligible consumers in the U.S.

And for the third straight year, health insurer Cigna is expanding its Medicare Advantage plans, growing into 108 new counties and three new states – Connecticut, Oregon and Washington – which will increase its geographic presence by nearly 30%.

Centene is also getting in on the act, expanding MA into 327 new counties and three new states: Massachusetts, Nebraska and Oklahoma. In all, this represents a 26% expansion of Centene’s MA footprint, with the offering available to a potential 48 million beneficiaries across 36 states.

The Centers for Medicare and Medicaid Services said in late September that the average premium for Medicare Advantage plans will be lower in 2022 at $19 per month, compared to $21.22 in 2021. However, Part D coverage is rising to $33 per month, compared to $31.47 in 2021.

Enrollment in MA continues to increase, CMS said. In 2022, it’s projected to reach 29.5 million people compared to 26.9 million enrolled in a Medicare Advantage plan in 2021.
 

Twitter: @JELagasse
Email the writer: [email protected]



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