CMS has suspended Gold Kidney of Florida from enrolling new members into one of its Medicare Advantage plans after state regulators found significant compliance and financial oversight failures. On Sept. 12, the Florida Office of Insurance Regulation issued a consent…
Medicare Advantage
Only 20% of Humana members are currently enrolled in Medicare Advantage plans with at least four stars for 2026, according to regulatory filings from the insurer. Preliminary 2026 Medicare Advantage star ratings data was available on CMS plan finder on…
Big insurers — from Humana to Cigna — are shying away from Medicare Advantage, exiting “unprofitable” markets, axing commission payments and even selling their businesses entirely. Now, other insurance companies have a chance to step up and gain market share,…
Almost half of Medicare Advantage enrollment growth since 2024 has been driven by special needs plans, according to an analysis from KFF. 4 notes on special needs enrollment in 2025: 1. In 2025, 21% of MA enrollees are in SNPs.…
AmeriHealth Caritas, a managed care organization, is growing its Medicare Advantage offerings, focusing on its Medicare-Medicaid dual-eligible special needs plans, according to a news release shared with Becker’s. In 2026, the insurer’s MA dual-eligible offering will be available in new…
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A federal judge has vacated a CMS rule that would have allowed the agency to claw back billions of dollars in alleged Medicare Advantage overpayments, siding with Humana in a closely watched legal battle. On Sept. 25, the U.S. District…
CMS has formally terminated UCare’s Medicare Advantage contracts after the insurer declined to sign agreements for 2026. The move impacts about 158,000 MA members in Minnesota and western Wisconsin, where UCare is the second-largest MA carrier with 26% market share.…
In one of the largest shifts in the Medicare Advantage landscape in recent years, Health Care Service Corporation has nearly quadrupled its Medicare Advantage membership after closing on a $3.3 billion acquisition of Cigna’s Medicare business in March. The deal,…
Higher utilization contributed to Medicare Advantage’s $5.7 billion underwriting loss in 2024, a marked reversal from serving as a source of earnings in the last five years, said an AM Best news release covering a Sept. 23 report. “Changes to…
Aetna is expanding a program that aims to reduce readmissions for its Medicare Advantage members to ten hospitals by the end of 2025. The insurer is currently implementing the clinical collaboration program at Merriam, Kan.-based AdventHealth Shawnee Mission, Houston Methodist,…