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Several Medicare Advantage Plan contracts with Humana lapsed on Oct. 31 after weeks of tense conflict. For patients covered by these plans, WakeMed could remain out-of-network “well into 2024 ...
Medicare Advantage plans may look less enticing to their 31 million beneficiaries next year. ... Humana, the second-largest Medicare Advantage insurer, recently sharply cut its earnings-per-share ...
On the one hand, the pressure Humana and others in the Medicare Advantage market are facing could be short-lived as the whole industry reacts to the surge in usage seen in late 2023.
Medicare Advantage ( Medicare Part C, MA) is a type of health plan offered by Medicare-approved private companies that must follow rules set by Medicare. Most Medicare Advantage Plans include drug coverage (Part D). Under Part C, Medicare pays a sponsor a fixed payment. The sponsor then pays for the health care expenses of enrollees.
Those patients, who receive Humana insurance through the State Health Plan, “remain covered,” she said. A Humana spokesperson said the company was still working with WakeMed to reach a resolution.
Medicare payments to the plans will total $27 billion more in 2023 than if patients were enrolled in traditional Medicare, the report projected. A new enrollment period for the plans began this month.
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