Thoughts on the Failed Aetna Humana Merger — A Philadelphia Perspective
Let me start by saying this, if you have a Humana Medicare Advantage plan in the Philadelphia Pennsylvania five county area you need to call BGA Insurance for a review this coming Annual Enrollment Period (October 15th to December 7th).
The following is an excerpt from the USA Today article dated 01/23/2017
“A federal judge Monday temporarily blocked the proposed $37 billion mega-merger between health insurance industry giants Aetna and Humana, ruling that the transaction would reduce competition for consumers.”
The narrative of the USA Today article is based on a whole 17 counties and a much larger market share. I, as a broker, will take a more selfish approach and base my blog on the Philadelphia five county area I write my business in.
Let me say I vehemently disagree that the merger is bad for seniors as explained by District Court Judge John Bates as written in the USA Today piece. I think it’s a great thing as far as my territory is concerned.
I cannot tell you how many people I visit each year who plead with me to help them out of their Humana HMO plan because their doctors or hospital do not participate in the network. Now there are two sides of the coin here. We know Aetna is a major player in the Medicare Advantage market in Philadelphia and Humana is not.
That does not mean Aetna is a better company than Humana or vice versa, as both are fine reputable companies. I can’t personally speak about the counties in Florida and the southern region where Humana has a very strong hold. I can provide numbers and graphs but that is not going to help explain my point of view.
Every Humana policyholder I meet, I ask why they chose the Humana plan. Number one answer given to me is, “I always see their commercials on television” and the next answer I hear is “the salesperson told me my doctor is in the network.”
First, if you live in the five-county area I’m sure you have seen the Humana television commercials marketing MA plans during the Annual Enrollment Period. The problem that seniors are running into when signing up for these plans is that the network lacks enough doctors and specialists who participate to satisfy all policyholders in the area.
The problem is once you decide on an MA plan, you are locked into that plan until the next Annual Enrollment Period. I can’t tell you how many people complain to me that the nearest primary doctor they can visit is 15 to 20 miles away.” Secondly, I do have an ethical issue with some brokers out there not doing their due diligence when sitting down with a Medicare recipient.
Some brokers are showing these plans and not doing the most important thing when selling an MA plan; making sure the Medicare recipient’s doctors participate in the network.
Treat every senior like you would want your parents treated. In a nut-shell it’s hurting seniors year after year by enrolling them into a plan that a lot of doctors and specialists don’t accept. Every BGA Agent is extensively trained to assist your journey into, and through, retirement by utilizing top rated insurance carriers and delivering old-fashioned personalized service.
In this fast-paced computer age we live in, your BGA Agent still makes house calls to ensure you fully understand your rights and entitlements.
With that said, I’m not going to sit here and spew that one company is better than the other company and I’m not talking as the whole market share amongst the carriers. I’m speaking about how this merger affects the Medicare Advantage market in the Pennsylvania area alone, because that’s where I specialize my business.
I am letting you know right away I have no other concerns about this merger and how it affects the market share nationwide, I only care how it affects the senior demographic on my geographical radar.
I’m not sure how this would reduce the competition and cause a monopoly as stated in the article because Independence Blue Cross, HealthPartners, Coventry, and United Health Care are all major players in the Philadelphia five county area. Not only that but MA policyholders also have a choice of choosing traditional Medicare along with a gap policy which further increases the competition and most importantly gives seniors more choices.
When I visit with seniors who have a MA plan that lacks a strong network, they can breathe a sigh of relief knowing they don’t have to be locked into a plan that does not benefit them. Because I am appointed with most of these carriers I know I can put their mind at ease and offer them a substantial network of doctors, specialists, and hospitals.
Joe Bachmeier is a co-founder of BGA Insurance Group
More news related to this article:
This article originally appeared on the BGA Insurance Group Blog