Health Care Service Corp. expands Medicare Advantage reach to 90 new counties

Health Care Service Corp. expands Medicare Advantage reach to 90 new counties

Health Care Service Corp. plans to expand its Medicare Advantage offerings to more than 90 counties that are home to 1.1 million Medicare-eligible residents.

HCSC billed the Medicare Advantage expansion as the largest in its history. The Chicago-based not-for-profit insurer covers almost 17 million people through Blue Cross and Blue Shield plans in Illinois, Montana, New Mexico, Oklahoma and Texas.

“Our goal as an organization is to provide our products and services for people to have access to affordable quality health insurance,” said Christine Kourouklis, president of HCSC’s Medicare operations.

Over the last decade, Medicare Advantage enrollment has skyrocketed—particularly among Black beneficiaries and those from medically underserved areas. Insurers want more of this profitable business.

“If you don’t become involved right now in the Medicare Advantage market, you’re getting behind the growth drivers,” said Brad Ellis, senior director of North American Insurance Ratings at Fitch Ratings.

The aging population and growing Medicare rolls, and the fact that Medicare Advantage plans cover 42% and rising of Medicare enrollees, give big insurers like UnitedHealth Group and Blue Cross and Blue Shield companies good reason to chase more Medicare customers, Ellis said.

HCSC’s Medicare Advantage bid is part of a larger trend among Blue Cross and Blue Shield companies, said Ari Gottlieb, principal at A2 Strategy.

“Medicare Advantage offers them an opportunity to capture much more of the premium dollar, to influence care more and to leverage their existing customer relationships and brand to help drive growth,” Gottlieb said.

Targeting rural and underserved areas means HCSC will likely face less competition from insurers concentrated in metropolitan areas, Ellis said.

“We’ve chosen expansion markets very carefully to select areas where we are confident we can successfully leverage our strong reputation and the strength of our relationships with doctors and hospitals, as well as offering coverage for new potential customers,” Nathan Linsley, senior vice president of government programs at HCSC, said in a news release.

To meet new Medicare Advantage members’ expected demand for medical care, HCSC has added 19,000 physicians and 2,800 hospitals and other facilities to its provider networks. The company is seeking CMS approval to offer Medicare Advantage policies in the new counties.

The insurer is developing a marketing strategy to encourage Medicare beneficiaries in its new service areas to switch to Medicare Advantage during the next open enrollment period, which runs from Oct. 15 through Dec. 7, Kourouklis said.

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Marie Maynes
Marie Maynes is a Sports enthusiast and writes for the Sports section of ANH.