Highlights:

• New C-SNPs for diabetes, chronic heart failure & cardiovascular disease available in Chicago, Pittsburgh, Philadelphia. Plans feature $0 PCP copays & certain specialists, low / $0 copay Rx for LIS members and an Extra Support Wallet.
• Medicare Smart Fit Plan: $0 premium plan designed for PDP customers considering switching to MA due to rising costs or those on mostly generic drugs. Includes dental, vision, hearing, robust Rx coverage and many no-cost benefits.
• Emphasis on value-based care, strengthening partnerships with Oak Street Health, CenterWell, One Medical, ChenMed and Sage Health
• Expansion of Aetna High Value Provider Incentive Program, offering Extra Supports Wallet bonuses for electing PCPs at one of the value-based care partners. Available in 18 states.
• Members will have access to an annual in-home visit from a licensed clinician with Signify Health, to help prevent & detect health conditions early and drive better care coordination for improved outcomes.

Expansions:

• D-SNP entering OK (state) & counties of Jonesboro AR & Grand Rapids MI
• D-SNP PPO entering states of MI, NC, OK, SC, WV
• MA-only entering new states of RI, MD, DC & many new counties

Highlights:

• 2nd largest SNP market share in our footprint, 2nd largest national Medicaid player
• Continue to focus on D-SNP for balanced growth and defend our non-SNP market position
• D-SNP plans with $0 copays in every county in our D-SNP footprint
• Expanding D-SNP plans with a simple combined allowance that includes Groceries, OTC, Utilities and Assistive Devices
• Improving access to dental providers with OON dental benefits
• Expanding MA footprint covers more than 3 out of 5 Eligibles nationally

Expansions:

• New states: KS

Highlights:

• All plans now offer dental, vision & hearing
• Dental HMO plans offered with 4 benefit designs including a plan with $0 cost. Dental Allowance customers can see any dentist but will save money using a Cigna Healthcare network dentist.
• 100% of plans offer supplemental eye exam in 2025.
• Hearing benefits available on 100% of plan in 2025 with a copay structure.
• HMO plans will offer post-discharge meals.
• Some plans will have deductibles.
• Part B giveback available in several states .
• New Living Needs Allowance (part of Cigna Healthy Today card) that allows customers on select DSNP plans more opportunity & flexibility on how they spend their money.
• In-network prior authorization required on specific benefits for all plans.

Highlights:

• Continue to offer industry-leading service & competitive benefits.
• Invest in benefits that provide the greatest good for the greatest number of people with benefits that can be delivered with a high level of consistency.
• Strong Part B Givebacks
• Expansion of Food & Home Card (available in over half of plans for 2025)- generous monthly allowances, can be used for groceries, utilities, rent/mortgage & OTC
• No specific dental network (outside of FL)- will have preloaded benefit cards specific for dental use, offering 9x the availability of dentists.
• Streamlined PPO designs- passive in/out of network structure

Expansions:

• New states: AR, GA, IN, KY, MS, MO, WA)
• Expanded states: IL, NC, OH, OR, PA, SC, TN, TX- 307 new counties in total

Highlights:

• Medicare Advantage plans continue to offer competitive benefits by focusing on what consumers care about most:
• Comprehensive dental coverage that includes deep cleanings, fillings and crowns, offered in 99% of the counties we serve
• New glasses every year, included in every plan with a vision benefit
• The Healthy Options allowance, including the ability to seamlessly carry over unused funds each month, on 95% of D-SNPs
• Plus, you can be sure our offerings are consistently designed your clients’ whole health in mind. Here’s what else you need to know about our 2025 MA/MAPD plans:
• 84% of members in plans with $0 premiums.
• 91% of members in plans with $0 primary care provider (PCP) copays.
• 100% of our D-SNP counties have a plan with at least $100 Humana Healthy Options Allowance™️ with rollover.
• 94% of members will pay $0 for Tier 1 medications, with no deductible, at any in-network retail pharmacy.
• 100% of the counties where we offer plans include a plan with dental, vision and hearing coverage and/or $0 Tier 1 copays.
• 98% of members have $0 Tier 1 and $0 Tier 2 copays at preferred cost-sharing mail-order pharmacies, with no deductibles.
• $0 copays for covered preventive dental services.
• MA members can use their dental benefits anywhere in our nationwide networks of more than 100,000 providers.
• Vision coverage with an allowance for eyeglasses or contact lenses on most plans nationwide.
• Some members with vision coverage will receive an additional $50 toward the purchase of eyeglasses or contact lenses when visiting a Vision PLUS provider.
• Hearing coverage, which includes hearing exams and coverage for hearing aids on at least one plan in every county.
• Elimination of the coverage gap (donut hole) and $2,000 maximum Part D out-of-pocket costs for all plans with prescription drug coverage.
• SilverSneakers® retained on 89% of plans.
• Go365 by Humana®, a healthy living and learning program, available on 98% of plans. Rewardable activities for MA and D-SNP members include Annual Wellness Visits, diabetic screenings, digital engagement and fitness.
• The virtual Humana Neighborhood Center® gives all Humana members access to no-cost, online, interactive health and well-being engagement programs from cooking classes to chronic condition management and a whole lot more.
• 2025 Humana USAA Honor Giveback plans: the only Medicare Advantage plans to carry the USAA name
• 100% of plans include a Part B Giveback ($20–$155/month).
• 100% of plans have $0 premiums.
• 100% of plans include dental.
• 100% of Humana USAA Honor Giveback MAPD plans include $0 prescriptions at all in-network retail pharmacies.
• All plans include vision and hearing.
• Freedom to get care close to home with provider networks of non-VA doctors, pharmacies (on Humana USAA Honor Giveback with Rx plans) and hospitals.
• Access to Humana Customer Care specialists, who collaborated with USAA to receive special training to better serve veterans (available to anyone with Medicare).

Expansions:

• Expanded D-SNP counties in: WA, MT, ND, MO, MD
• Expanded C-SNP counties in: AZ, AR, IL, IN, KY, MI, MN, NM, TX

Highlights:

• 2 new products added to portfolio:
• AARP Medicare Advantage Access Plan
• Low-cost sharing designed plan
• Launching in 6 states reaching 5.7 M eligibles in : AZ, MT, NC, TN, VA, WA
• AARP Medicare Advantage CareFlex Plan
• The CareFlex plan provides members a quarterly credit on a Visa debit card that can be used to pay for out-of-pocket costs on most Part A & B services
• Launching in 6 states reaching 7.8M Eligibles in: WI, MO, IL, AZ, TX, FL

Expansions:

• MAPD Essentials & MAPD Extras plans now in 17 states reaching 16M eligibles (WA, OR, NV, AZ, NM, UT, CO, NE, KS, MO, TX, IL, IN, OH, KY, SC, GA)
• C-SNP now available to 70% of eligibles. 50% of all UHC members have an eligible condition. Now available in 24 states (22 new) reaching 19.3M Eligibles (New States: DE, IA, ID, IL, IN, KS, KY, LA, MA, ME, MN, MS, NC, NM, NY, OH, OK, OR, PA, RI, VA, WA)
• D-SNP Due to the changes in D-SNP enrollments, focusing on plans for fully dual eligibles that are designed to attract and retain members. 36 States (19 New) reaching 9.2M dual eligibles. (New States: AL, AR, GA, KY, LA, ME, MI, MO, MS, NC, NM, NV, OH, PA, RI, SD, UT, WI, WV)

Highlights:

• 43 newly designed plans going to market.
• Strategic partnership between Wellcare and Mutual of Omaha will continue to offer competitive co-branded plans in five states: GA, MO, SC, TX, WA.
• Wellcare continues to partner as the American Legion’s official Medicare Advantage provider. New plans will be offered in four states: FL, IL, NE, NC.
• PDP: 3 products offered in all 34 regions across all states + DC.
• 5-tier formulary on all 3 plans
• Plans offer competitive formularies that are up to 86% aligned or favorable in coverage and tier placement for the top 400 drugs (96% of Medicare utilization) compared to plans nationwide.
• The Value Script plan will continue to offer members a cost-effective option, with one of the lowest premiums in the nation! All plans feature a $0 copay on Tier 1 prescriptions when filled at a preferred pharmacy.
• PDP members will also pay $0 for all adult, ACIP-recommended Part D vaccines and no more than $35 for a 30-day supply of all covered insulins.
• NEW for 2025, the Part D benefit consists of three phases: annual deductible, initial coverage, and catastrophic coverage. In addition, member’s out-of-pocket prescription costs will not exceed $2,000 with the option to pay in the form of monthly payments over the course of the plan year.

Expansions:

• MAPD expanding into Iowa and 126 new counties in CA, IL, IA, MS, NY, TX, WA

Highlights:

• $0 Premiums All plans have a $0 Part C plan premium D-SNPs will have LIS premium, but member premium will be subsidized according to their LIS level
• Competitive Maximum Out-of-Pocket Limits (MOOP) Competitive MOOPs for all plans Select PPO plan MOOPs will be the same for in-network and out-of-network
• Transportation All HMO plans include transportation All ESRD plans include UNLIMITED transportation
• Healthy Food / Utility Benefits Majority of plans have food and utility purses Utility benefits to be offered to most of Zing’s targeted populations
• Formulary $0 insulin and competitive Part D formulary design on all plans $0 copay on Tier 6 Part D formulary on all C-SNPs for key related drugs
• Prior Authorizations Our HMO plans have no prior authorization required for PCP and Specialist office visits Our PPO plans have no prior authorization required for in and out-of-network PCP and Specialist office visits
• Special Supplemental Benefits for the Chronically Ill (SSBCI) Select plans will have a monthly allowance (no roll-over) that can be used toward OTC, healthy foods, and/or utilities Members must meet qualifications to receive this benefit. Not all members will qualify.
• Value-Based Insurance Design (VBID) LIS members in select plans will have a monthly allowance (no roll-over) that can be used toward healthy foods and/or utilities Eligibility for the Model benefits or RI Programs under the VBID Model is not assured and will be determined by the Zing Health after enrollment, based on relevant criteria (e.g., clinical diagnoses, eligibility criteria, participation in a disease state management program).

Expansions:

• New states: IN, MI, MS, OH, TN