Kansas City Blue Cross Advantage Changes 2025
If you are currently enrolled in a Blue Cross Blue Shield of Kansas City Medicare Advantage Plan, I’ve got some very important news that will affect you during this Annual Election Period.
Blue Cross Blue Shield of Kansas City will discontinue all of their Medicare Advantage plan offerings for 2025. This will affect around 30,000 members in the state who have a Medicare Advantage plan.
This means that if you are enrolled in one of their plans, you will indeed have to select a new company if you want to stay in a Medicare Advantage plan for 2025.
I highly recommend that you keep an eye on your mail. You should be receiving an annual notice of change (or a statement from Blue Cross Blue Shield of Kansas City about this change), which will take effect on January 1st, 2025. So, your plan will be good through the remainder of 2024.
I can’t emphasize enough the importance of keeping an eye out for this letter. Most people receive it every year during the Medicare Annual Election Period—which runs from October 15th through December 7th—and because they’re happy with their plan, they throw it away.
Do not throw it away this year. It’s imperative.
Hi, my name is Mark Prip, and I have been helping people understand Medicare for the last 15 years. Today, I’m going to dive right into the changes that we’re seeing from BCBS of Kansas City regarding the 2025 plan year.
Update: If you have received notice that your plan is changing or ending, please call us to find an alternate option: 888-414-4547
Kansas City Blue Cross Announcement
Let’s start by looking at a statement from Erin Stucky, Blue Cross President and CEO says,
“We explored every alternative path for our Medicare Advantage members and are disappointed we must exit this line of business. We value our MA membership and are committed to providing uninterrupted quality service to our current MA membership through the end of 2024.”
That statement is taken directly from the article on fiercehealthcare.com. I’ve linked to it in the sources at the bottom of this page, so if you want to read the full article, you can access it there.
Secondly, I went directly to the Kansas City Blue Cross website, and you can see in the screenshot below that their homepage directly states:
“Blue Cross of Kansas is exiting the Medicare Advantage market at the end of 2024.”
They’re proposing they have alternative options, which are Medicare Supplement plans.
So, if you are interested in a Medicare Supplement plan with Blue Cross of Kansas, that’s an option; Medicare Advantage plans will no longer be an option with them.
The question is: why is this happening?
Why Is This Happening?
Let’s take a look at this (according to the article from Fierce Healthcare) :
“Blue Cross of Kansas said the insurer cannot economically compete at scale because of the plan’s small Medicare Advantage membership.
In March, the Centers for Medicare & Medicaid Services (CMS) announced it would follow through with decreasing benchmark payments by 0.16%, though the agency maintains the average payments to insurers will increase by 3.7% in 2025.”
Which Members Are Affected?
So, the even bigger question is: who will be affected by this change?
This will happen across the whole state of Kansas. If you have a Kansas City Blue Cross Blue Shield Medicare Advantage plan, it affects you. Some companies will make these changes to smaller segments of the Medicare Advantage book of business, but in this situation, the entire membership is ending.
Unfortunately, having been in this space for many years, this comes as no surprise to me. We have seen companies come into the Medicare Advantage space and then leave. It’s very difficult to sustain profitability with the medical loss ratios coupled with the amount that CMS is reimbursing these companies for each member’s enrollment.
When the CMS announcement came out, many insurers were unhappy about the changes for 2025. They say it won’t properly cover all medical claims, medical loss claims are going up, and the reimbursement rate is not enough to satisfy that.
This change is happening all over the country. In fact, I recently did a video on Aetna, which is dropping close to 400,000 members throughout the country.
I also did a video on the Humana changes. They are doing something similar in terms of roughly half a million people, or more, being affected in different areas of the country.
2025 is going to be a much different year than we’ve seen in the past, and many companies are “gutting” (unfortunately, that’s a harsh word). They’re looking at their profit margin and medical loss and determining that some companies can’t do it at all or are having a harder time in different pockets of the country.
The good news is that you do have alternative choices. Let’s take a look at a couple of recommendations I would make to replace this loss of coverage with another carrier.
Finding Another Medicare Advantage Provider
If you want to find another Medicare Advantage plan, the good news is that finding a replacement company won’t be that hard.
Here’s what I recommend:
Get ahead of this change by making a list of your current doctors, hospitals, or any medical providers that you regularly see. Then, make a list of all of your prescription medications, the dosage, and the correct spelling of the names of the prescriptions that you’re on.
This way, when you go check out another company (let’s say you look at United Healthcare or whomever it may be), that’s going to be the imperative information that you’re going to want—to verify that a new company covers those medical providers, doctors, hospitals, or whoever you’re used to seeing.
That list of medications ensures that they will also cover your medications just as well as your previous plan had.
Switching to a Medigap Plan
The other opportunity that you have by losing your Blue Cross of Kansas Medicare Advantage plan is that this creates a guaranteed issue right.
What I mean by that is – you can now switch to a Medigap plan.
Since your Medicare Advantage plan won’t renew, you’ll now have a guaranteed issue right period when you can apply for a Medigap plan without undergoing medical underwriting. If you’ve been wanting a Medigap plan but couldn’t get one because of medical issues, now is your chance to enroll.
So, let me elaborate a little bit more.
Medicare Advantage plans do not have any medical underwriting.
They have no qualifications that prevent you from getting a plan in terms of medical conditions or preexisting conditions.
Once you’ve been on Medicare for a while and you want to leave a Medicare Advantage plan and switch to Medigap, that Medigap company has the right to ask health questions in order to qualify you.
Unfortunately, some folks would love to switch from a Medicare Advantage plan to a Medigap (or what’s also called a Medicare Supplement) plan, but they simply don’t qualify.
This loss of coverage with Kansas City Blue Cross will automatically give those 30,000 members a guaranteed issue right. That means they can now enroll in a Medigap plan without medical underwriting.
With Medigap:
- You will not deal with provider networks
- You will not deal with referrals
- You will not have prior authorizations
- You will not experience annual benefit changes
Medigap plans come at a higher cost, but they are far superior in coverage if you can afford it.
But if you cannot, and Medicare Advantage is your preferred method because of its lower monthly cost, then I would encourage you to consider finding and shopping for another Medicare Advantage plan during this Annual Election Period.
Final Thoughts
Here are my final thoughts: this change is not isolated to Kansas City Blue Cross. It’s happening all over the country for 2025.
I’ve seen more changes coming for 2025 than I have seen in the last 15 years.
So, if you need help comparing alternative Medicare Advantage plans, we’d be happy to help. You can call us directly, and we can set up a needs analysis. We’ll help you verify your drugs and providers and then tell you which company is available in your county that would be the most suitable fit.
You can also visit Medicare.gov to compare plans there.
Hopefully this gives you the knowledge and tools you need to quickly find an alternative and avoid being caught without coverage. Thanks!
Source: Fierce Healthcare
FAQs
- What is a guaranteed issue right?
- How can individuals find a suitable alternative Medicare Advantage plan?
- Are there any other options for those who have lost coverage from their Medicare Advantage plan?
