Upcoming Changes for Mutual of Omaha

Mutual of Omaha’s first Medicare Advantage plan will go on sale this fall in Cincinnati, the company said Tuesday, the start of Mutual’s strategy to create a nationwide Medicare Advantage product.

The Omaha insurance company and its Advantage partner, Lumeris Inc., contracted with two Cincinnati health systems, TriHealth and St. Elizabeth Healthcare, to provide medical care for Advantage customers starting Jan. 1. Marketing will begin when 2019 Medicare enrollment opens Oct. 15.

Mutual’s Medicare Advantage plans will use “narrow” medical networks, reducing costs by limiting coverage to certain physicians, hospitals and other care providers.

Mutual chose Cincinnati because of its growing number of Medicare-aged patients and “like-minded health care organizations in the region,” said Amber Rinehart, a Mutual senior vice president. A Mutual spokesman declined to say whether the plans will be sold in Omaha this year or to name other cities on this year’s list.

Lumeris, based in St. Louis, arranges health provider networks and will manage the plans in each city. Mutual will own its Medicare Advantage name and provide brand, marketing and distribution expertise and capital.

Medicare Advantage plans are sold by private companies as an alternative to government-run Medicare, providing traditional coverage plus other benefits. Medicare Supplement plans, also known as Medigap, are sold by private companies to help pay some costs not covered by Medicare.

Mutual has long sold Medicare Supplement plans, but enrollment in such plans is declining nationally. By 2027, according to the Kaiser Family Foundation, the share of Medicare recipients using Advantage plans is expected to grow from about one-third to 40 percent.

A group of doctors formed Lumeris about 10 years ago to find better ways to provide health care. The group also started its own Medicare Advantage drug plan, now known as Essence Healthcare, with about 65,000 members in the St. Louis area.

TriHealth and St. Elizabeth’s formed the Health Solutions Network in 2014 to provide better health care and better value, said Dr. Randall Curnow, TriHealth medical director.

TriHealth has six hospitals and more than 130 other locations in the Cincinnati area. St. Elizabeth has more than 115 primary care locations in Kentucky, Indiana and Ohio.

Original Article By: Steve Jordon / World-Herald staff writer
Originally Published on: omaha.com / Live Well Nebraska
Link: https://www.omaha.com/livewellnebraska/mutual-of-omaha-expanding-its-medicare-advantage-product-starting-with/article_105345f1-7e76-5f85-a92e-7f30d660da60.html