Success of PPOs, OTC Coverage May Drive 2021 MA Offerings

An earlier version of this story incorrectly stated that during the 2020 Medicare Annual Election Period, Bright Health increased its membership by 36% to more than 5 million members and Devoted Health nearly tripled in size to 4.3 million lives. Bright Health has more than 5,000 members, and Devoted Health has 16,000 enrollees. This version has been corrected.

Although individual HMO plans continued to capture the bulk of enrollment in Medicare Advantage plans during the 2020 Annual Election Period (AEP), overall gains by individual PPO plans were not far behind those of the historically popular HMOs, according to a recent analysis from Pareto Intelligence, a Convey Health Solutions company. Based on CMS’s February data release (which reflects enrollments accepted through Jan. 1 and is regarded as demonstrating the final AEP figures), Pareto estimates that enrollment in individual PPOs climbed 10.25% during the AEP to more than 4.8 million enrollees, outpacing individual HMO growth of 5.43% to nearly 11.3 million members.

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