Blue KC announces it will exit Medicare Advantage market
Blue Cross and Blue Shield of Kansas City (Blue KC) announced May 30 that we have made the difficult decision to exit the Medicare Advantage market at the end of 2024.
About our decision
Medicare Advantage plans across the country continue to be challenged by heightened regulatory demands and rising market and financial pressures. Despite our actions to create a more viable, scalable solution for our valued Medicare Advantage members, the required financial investment is not sustainable.
Even as the largest not-for-profit health insurer in Missouri, serving 32 counties including Johnson and Wyandotte in Kansas, our Medicare Advantage membership does not provide the scale required to compete in today’s evolving and challenging market. Our Medicare Advantage membership represents three percent of the roughly one million people who trust in Blue KC to provide their health and wellness coverage, and over the past five years Medicare Advantage has disproportionately and negatively impacted our financial performance.
In the first week of October, Medicare Advantage members will receive information on their options for 2025 and directions on how to get help with understanding their choices. Here are important dates to prepare for this change:
| Important Dates | Summary |
|---|---|
| First week of June | The organization alerted impacted members and will provide more information about alternative 2025 coverage options, including Blue KC’s Medicare Supplement plans. |
| October 2, 2024 | On or around this date, members will receive a Medicare notice of the non-renewal of their Blue KC Medicare Advantage Plan. This letter will be sent by Blue KC. It will contain a list of alternative Medicare Advantage plan options available for them to consider. The letter will also include a Certificate of Creditable Coverage that provides the member guaranteed issuance rights for a Medicare Supplement policy. This means the member will not have to experience any medical underwriting to assess their health status if they choose to apply for a Medicare Supplement policy instead of Medicare Advantage. |
| October 15 – December 31, 2024 | The Medicare Annual Enrollment Period is October 15 – December 7. Due to the member’s current plan no longer being offered in 2025, the open enrollment period will be extended through December 31, 2024. During this period, the member may choose a new health plan that becomes effective January 1, 2025. |
| December 31, 2024 | The Annual Enrollment Period and the member’s coverage under Blue KC Medicare Advantage ends. The member must select a new plan by December 31, 2024, to ensure they have coverage for January 1, 2025. If the member waits to enroll after December 31, 2024, their coverage will default to Original Medicare on January 1, 2025, and they will lose prescription drug coverage. Original Medicare will continue until the member chooses a new plan, and it becomes effective. |
| January 1 – February 28, 2025 | Because the Blue KC Medicare Advantage plan is ending, Medicare provides members with an extended Special Enrollment Period beginning January 1, 2025, through February 28, 2025. This gives members a second opportunity to choose a new plan. The member’s coverage will become effective the first day of the month after the new plan receives their enrollment request. |
Supporting our Medicare Advantage members
We will continue to provide high-touch support and uninterrupted access to care to our Medicare Advantage members throughout the remainder of contract year 2024. We thank you in advance for those who will play a role in helping Medicare Advantage members find quality alternative coverage for 2025.
Supporting our agent partners
Blue KC recognizes the value and support of our agent partners through this change. Agent and agency compensation will remain consistent with Blue KC contracting and in accordance with CMS compliance for the remainder of 2024.
Looking ahead
Exiting the Medicare Advantage market will position Blue KC for improved financial performance to serve our members and remain the leading health insurance provider for Kansas City. Thank you for your continued trust in us. It is important to note this does not impact our Medicare Supplement coverage. If you have questions, we encourage you to email us at BlueKCMABroker@BlueKC.com.
NOTE: We will be working directly with agents managing EGWP coverage on communication strategy in partnership with the agent and employer.
