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Wellmark announces plan to enter Medicare Advantage market in 2022


Wellmark Blue Cross and Blue Shield announced Tuesday it will offer new Medicare Advantage plans to Iowans and South Dakotans this fall, pending approval from the Centers for Medicare & Medicaid Services. Its new affiliate, Wellmark Advantage Health Plan, will offer the new Medicare Advantage options during this year’s annual election period Oct. 15 through Dec. 7, for coverage that begins Jan. 1, 2022.  

“We are excited to introduce Wellmark Advantage Health Plan and our products to Iowa and South Dakota,” said Jason Humphrey, Wellmark’s Vice President of Medicare Advantage. “Our Medicare Advantage plans will provide consumers with the benefits, network and price points that meet their unique needs. Just as important, the plans are backed by the quality, value and trust they have come to expect from Wellmark.”

Wellmark currently offers Medicare Supplement plans among its plan offerings. Those plans, also known as Medigap policies, typically cover copays, deductibles and other expenses not covered by Medicare.

Medicare Advantage, also known as Medicare Part C, combines traditional Medicare — parts A and B — into one comprehensive, easy-to-manage plan along with additional health-enhancing benefits. Plans often include coverage for prescription drugs, routine vision and eyewear coverage, dental coverage, hearing aids, fitness center memberships, over-the-counter medications/supplies, and clinical support.

The Medicare Advantage market — a highly profitable niche for health insurers — is expected to account for more than half of all Medicare enrollees in the United States by the end of this decade.  

Gross profit margins for Medicare Advantage plans increased by more than 40% in the first half of 2020 over 2019, rising from $158 per member per month in June 2019 to $222 per member per month in June 2020.

In 2020, nearly four in 10 (39%) of all Medicare beneficiaries – 24.1 million people out of 62 million Medicare beneficiaries overall – were enrolled in Medicare Advantage plans, according to data from the Kaiser Family Foundation.

In the past decade, Medicare Advantage enrollment has more than doubled from 11.9 million Americans, or 25% of Medicare beneficiaries. The Congressional Budget Office projects that the share of all Medicare beneficiaries enrolled in Medicare Advantage plans will rise to about 51% by 2030.

“We know consumers have varied needs and want choices when it comes to health insurance,” Humphrey said. “We are confident the new Medicare Advantage options will complement Wellmark’s existing Medicare product offerings to provide consumers with solutions that best meet their needs. We look forward to sharing more details later this year pending final approval by CMS.”

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