DEJA VU: Anthem and Humana Have Not Come to Agreement Yet with Genesis HealthCare System

Anthem Blue Cross and Blue Shield of Ohio, a subsidiary of Elevance Health, along with Humana, has announced that the Genesis HealthCare System will be leaving their Medicare Advantage network starting January 1, 2024.

Genesis HealthCare System, ranked top 50 in the country for heart care, is centered around the Zanesville area and stretches into parts of Columbus, Ohio—making it the largest healthcare provider in Southeast Ohio.

Who This Affects

This network change affects seniors who have an Anthem or Humana Medicare Advantage plan in the six-county region of southeastern Ohio, which includes Muskingum, Morgan, Perry, Coshocton, Noble and Guernsey counties.

This does not affect Ohio seniors on a Medicare Supplement plan because they don’t need to stay within any networks. However, seniors on an Anthem or Humana Medicare Advantage plan should review their Advantage plan options before the end of the Annual Enrollment Period (October 15 through December 7). Seniors can also change plans once during the new Open Enrollment Period (January 1 to March 31).

How Will It Affect You?

Seniors on a Humana or Anthem Medicare Advantage plan who continue to see their doctor or medical provider in the Genesis HealthCare system may pay exponentially higher out-of-pocket costs for services they receive. Nothing is worse than going to see your doctor and then finding a big fat bill in the mail because your plan stopped covering your providers. And no senior wants to change all their doctors just to keep their Medicare Advantage plan.

What Can You Do About It?

The easiest thing to do is review your Medicare Advantage plan options either during the Annual Enrollment Period or the Open Enrollment Period. It takes 5 minutes to fill out our simple onboarding form (which gives us a list of your prescription drugs and doctors so we can compare plans that offer the best coverage), and then we simply call you with the results.

Of course, seniors can change their Medicare Advantage plan ANY TIME of the year if they change to a Five-Star plan. To jog your memory, a Five-Star Medicare plan is a plan that’s so highly rated by CMS that it allows seniors the opportunity to switch to the plan ANY TIME of the year. The good news is that there are some Five-Star Medicare Advantage plans in these counties to consider. Usually they offer a lot of benefits and keep out-of-pocket costs as low as possible.

Why Does This Keep Happening!?

You may have read our article recently about Anthem and Mercy Health networks similarly planning to separate from the service area. And then Cigna announced that it’s no longer taking Cleveland Clinic doctors in its Medicare Advantage plans. Why does this keep happening? Especially with Anthem?

Anthem has been accused by Mercy Health of withholding payments amounting to over 100 million dollars, and yet Mercy Health and Anthem patched things up literally the day before the slated separation. This threw everything into chaos, leaving Ohio seniors uncertain whether their plan would still cover their doctors or not.

This is a clear indication that negotiations for Medicare services are getting tighter and will only get more strained heading into a deep recession. Seniors can expect more disruptions like this to their healthcare going forward. The best thing you or any senior in Ohio can do is fill out our ONBOARDING FORM that gives us some required info like your drugs and doctors, and then visit our calendar to PICK A TIME that’s convenient for you, to review your plan coverage options with your over the phone from the comfort of your own home. 

At least with us in your corner from now on, you’ll never have to worry about ANY network disruption, because we’re an independent insurance agency that can compare all the major Medicare companies in your area. So you’ll get to keep your doctors, lower your out-of-pocket costs, and get better benefits!