Clover Health sees Medicare Advantage enrollment jump 25%

Photo: Marko Geber/Getty Images

Clover Health's Medicare Advantage enrollment for 2022 has beaten expectations, increasing 25% over the previous year, according to the insurer.

This outpaces the overall industry growth average of about 10% year-over-year. Clover began the year already above its 2022 average MA membership guidance of 82,000 lives.

Clover experienced membership growth in a number of service area counties across Georgia, New Jersey, Pennsylvania and South Carolina. The company's MA plans are available to eligible people in 209 counties across nine states.

This includes almost tripling membership in Georgia, where Clover's MA plans are available in 146 of the state's 159 counties. Last year, Clover increased the breadth and depth of its provider network throughout Georgia with the addition of dozens of hospitals, health systems and provider partners across the region, aligning about 5,000 new primary care physicians and specialists with its Medicare Advantage PPO network.

In explaining the reasons behind the MA plan growth, President Andrew Toy credited benefit-rich health plans with low out-of-pocket costs, and a philosophy of encouraging beneficiaries to engage with the healthcare system, and their PCP in particular.

"We believe our dramatic growth in Georgia demonstrates how the model we honed in New Jersey is replicable in more states and look forward to further establishing Clover's MA presence in key markets this year," Toy said in a statement.

Clover has also equipped its PCPs with technology containing patient information and clinical recommendations at the time of the visit, which the insurer said allows for more personalized care.

WHAT'S THE IMPACT

There's no doubt that Medicare Advantage has become a popular option for consumers. For many seniors, MA is the preferred health insurance because of its low upfront monthly costs and added benefits. MA plans will continue to offer a wide range of supplemental benefits this year, including eyewear, hearing aids, both preventive and comprehensive dental benefits, access to meals (for a limited duration), over-the-counter items, fitness benefits and worldwide emergency/urgent coverage. 

In addition, the percentage of plans offering special supplemental benefits for chronically ill individuals will increase from 19% to 25%.

According to the Centers for Medicare and Medicaid Services, MA is projected to reach 29.5 million people, compared to 26.9 million in 2021.

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 with $21.22 in 2021. However, Part D coverage is rising to $33 per month, compared with $31.47 in 2021.

THE LARGER TREND

Insurers are expanding their Medicare Advantage offerings at a decent clip, with Humana announcing last fall it would debut a new Medicare Advantage preferred provider organization (PPO) plan in 37 rural counties in North Carolina in response to market demand in the eastern part of the state.

Around the same time, 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.

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. This represents a 26% expansion of Centene's MA footprint, with the offering available to a potential 48 million beneficiaries across 36 states.

Not everything is going swimmingly, however. Earlier this month Humana drastically reduced its Medicare Advantage enrollment estimates for 2022 due to a large number of terminations during the last enrollment period, revealing in a new filing with the Securities and Exchange Commission that the former projection of 325,000 to 375,000 new MA members has been slashed to 150,000 to 200,000 new members.

Humana also expects group MA membership to be generally flat throughout this year, as it doesn't anticipate any large accounts will be gained or lost.
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com