Advisory For One Million Seniors With Aetna and Humana Medicare Advantage Plans

One million seniors with Aetna and Humana Medicare Advantage coverage may need new coverage for 2025.Photo byAmerican Association for Medicare Supplement Insurance

Jesse Slome is director of the American Association for Medicare Supplement Insurance (AAMSI) a national advocacy organization that supports insurance professionals who market Medicare solutions. This post may include affiliate links. If you purchase anything through these links neither the author nor the Association earn a commission. However, agents who sell Medicare plans do.

In recent months, both Aetna and Humana have announced significant changes to their 2025 Medicare Advantage plans.

Aetna announced plans to reduce coverage in specific geographic areas for 2025. Others with Aetna coverage may find they have more limited access to certain specialists or services. Specifically, Aetna anticipates losing approximately 10% of its membership due to these changes, as it "aims to realign its business strategy and improve profitability".

Humana has also announced it will be exiting 13 Medicare Advantage (MA) markets in 2025. Approximately 560,000 members, which constitutes about 10% of Humana’s individual MA membership base, will be affected by these cutbacks.

However, the company anticipates that it will retain about half of those members by transferring them to other plans. Reviewing statements from the companies mean around one million current seniors with Aetna or Humana Medicare Advantage coverage will likely be affected as this year's Medicare Annual Enrollment (AEP) season approaches.

The decision by these companies to cut coverage can be attributed to several key factors. These include financial pressures due to rising costs for medical care, pharmaceuticals, and administrative expenses. Changes in benefits typically reflect the cut services that are high in cost or may not yield expected healthcare outcomes.

Seniors who currently have Medicare Advantage coverage with either Aetna or Humana should pay particular attention this year for the arrival of notices and information from the company. These are typically sent out in September in order to provide ample time in advance of Medicare's AEP start on October 15th.

While 2025 plans for all Medicare Advantage plans are not currently available, a quick check of online plan comparisons can give you a sense of how many different plans are currently available. According to 2024 Medicare Advantage plan data, the average senior has 40 different plans available.

If you are affected, plan to start looking into your options when Medicare AEP begins. The period to find and switch coverage lasts only 53 days. And while that seems like a lot of time, most local Medicare Advantage insurance agents find themselves booked solid as the final days approach.