UnitedHealthcare, Aetna eye Medi-Cal market

Next year UnitedHealthcare and Aetna hope to join the country’s largest state Medicaid program, Medi-Cal, in San Diego and Sacramento Counties, California Healthline reported.

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State officials opened Medi-Cal managed care to other insurers because current contracts in the two counties have been in place for some time, the California Department of Health Care Services said. Medi-Cal managed care, currently made up of 22 insurers, allows insurers to receive a fixed amount from the state per enrollee.

Hartford, Conn.-based Aetna wants to partake in the program because of Medi-Cal’s expansiveness, a spokesperson told California Healthline. The insurer hopes one of its plans, Aetna Better Health, will eventually cover 150,000 Medi-Cal members and extend beyond San Diego and Sacramento Counties.

As for Minnetonka, Minn.-based UnitedHealthcare, a spokesperson said the insurer’s decision to enter the program stems from its success in other state Medicaid programs, California Healthline reported. The insurer already has 3.7 million employer-based or Medicare members in California. However, UnitedHealthcare recently announced its exit from most state exchanges next year, including Covered California.

The insurers’ start date with Medi-Cal plans will be July 2017, pending state approval. 

More articles about payer issues:
Anthem to DOJ: Cigna merger will boost insurance market
CareFirst BCBS revises rate requests in Maryland
Insurers, consumers debate up to 48% rate increases in Pennsylvania

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