Are you currently enrolled in a Medicare Advantage Plan with Blue Cross Blue Shield of Kansas City (Blue KC)?
Blue KC just announced that they are leaving the Medicare Advantage Market at the end of 2024. If you’re enrolled in one of their Medicare Advantage Plans, this means that you will lose your Medicare coverage in 2025 if you don’t take action.
In this article, we’ll explain why Blue KC is leaving the Medicare Advantage market, what you can do if you’re enrolled in one of their plans, and answer some commonly asked questions about this topic.
Why Is BCBS of KC Leaving Medicare Advantage?
According to the company, Blue Cross Blue Shield of Kansas City is leaving the Medicare Advantage market due to “heightened regulatory demands and rising market and financial pressures.”
In recent years, CMS (Centers for Medicare and Medicaid Services) has been releasing regulations that are putting pressure on Medicare Advantage Plans. In April, CMS announced a 3.7% increase in payments to Medicare Advantage Plans for 2025. Many insurance companies were unhappy with this increase since it was lower than expected.
Blue Cross Blue Shield of Kansas City has also stated that their relatively small Medicare Advantage membership cannot compete with “today’s complex and continuously changing market.”
“We explored every alternative path for our Medicare Advantage members and are disappointed we must exit this line of business. We value our MA members and are committed to providing uninterrupted, quality service to our current Medicare Advantage membership through the end of 2024.” – Erin Stucky, Blue KC President and CEO.
What This Means for Enrollees
If you’re currently enrolled in a Medicare Advantage Plan through Blue Cross Blue Shield of Kansas City, your coverage will end at the end of 2024.
Blue KC has informed its enrollees of these changes for 2025.
Note: if you’re enrolled in another type of plan by BCBS of KC, such as their Medicare Supplement Plans, Medicare Part D prescription drug plans, or their other plans, you shouldn’t be affected by this change. BCBS of KC is only leaving the Medicare Advantage market in 2025.
5 Things You Can Do About These Changes
If you’re feeling nervous or unsure of what exactly to do next, here’s a quick checklist you can follow to ensure a smooth transition into a new plan:
- Review Your Coverage Details
Before searching for another plan, you may want to review your coverage details. This should give you a benchmark to compare your other plan options.
This may also be a good time to refresh your memory on the differences between HMO and PPO Medicare Advantage Plans.
- Check Which Other Plans Your Doctor Accepts
If you’d like to continue seeing your preferred doctor, you can ask your doctor or a Licensed Insurance Agent who can show you your options.
Remember, Medicare Advantage Plans typically have networks. This means that if you have an HMO plan, you usually won’t be covered if you get services outside your plan’s network (except in emergencies). Meanwhile, if you have a PPO plan, you may have higher copays if you go out-of-network.
That’s why it’s important to know which other plans your preferred doctor accepts before choosing a new plan.
- Shop For Plans in Your Area
Next, you’ll want to shop around for plans in your area early on. You usually can’t switch plans until the Annual Enrollment Period (Oct 15 – Dec 7), but knowing your options before this can make your transition smoother.
Before choosing a plan, you’ll want to check several things, like its coverage, copays, maximum out-of-pocket limit, network, prescription drug formulary, prescription drug copays, and more.
- Consider a Medicare Supplement Plan
If you can’t find a Medicare Advantage Plan fit for you, you may also want to consider enrolling in a Medicare Supplement Plan.
There are several differences between Medicare Supplement Plans and Medicare Advantage Plans, so make sure to study these differences before making a decision.
Most of the time, you must undergo medical underwriting before Medicare Supplement Plans accept your application. This means that you may not qualify for a Medicare Supplement Plan if you have a medical condition.
However, you may qualify for Guaranteed Issue Rights because you are losing your BCBS of KC coverage due to the plan leaving the Medicare Advantage market. This allows you to enroll in some Medicare Supplement Plans without medical underwriting (and the plans have to take you in!).
You can read more about this on Medicare’s website, or you can call or text us at +1 877-360-6565 (TTY: 771) for assistance.
- Switch Plans During the Annual Enrollment Period
The Annual Enrollment Period (AEP) runs every year from October 15 to December 7. During this time, you may switch to another Medicare Advantage Plan, or you can revert back to Original Medicare and apply for a Medicare Supplement Plan.
Any changes you make during the Annual Enrollment Period should take effect on January 1 of the following year.
Note: if your Medicare Advantage Plan is exiting the market, you qualify for a Special Enrollment Period that runs from December 8 to the last day of February of the following year. During this period, you may enroll in a Medicare Advantage Plan or a Medicare Part D prescription drug plan available in your area.
Bonus: Contact a Licensed Insurance Agent
If this all seems overwhelming, you can always contact a licensed insurance agent for help. Make sure that the licensed insurance agent you talk to contracts with several different insurance companies, so they can provide unbiased advice on which plans may be a better fit for you.
Aside from that, licensed insurance agents can also help you compare prescription drug costs with different plans or help you switch to a Medicare Supplement Plan using your Guaranteed Issue Rights.
Since licensed insurance agents can help you at no cost to you! So, if you need help, you can call or text our team of licensed insurance agents at +1 877-360-6565 (TTY: 771).
Conclusion: Ready For a New Plan?
Blue Cross Blue Shield of Kansas City leaving the Medicare Advantage Plan came as a surprise, especially to those enrolled in the plan.
We hope that this quick article explains why Blue KC made this decision and prepares you for the next steps you should take to make sure you’re covered next year.