Aetna Medicare Advantage Changes for New Mexico
If you have Aetna Medicare Advantage plan coverage now or may become eligible in 2025, it’s important to understand that Medicare plans in your area are experiencing some big changes.
What Happened?
On August 7, 2024, CVS Health executives, the company that owns Aetna, told healthcare analysts that many of its 2025 Medicare Advantage plans will be leaner than the 2024 plans. With rising medical costs outpacing government reimbursement increases, CVS Health prioritizes profit margins over membership growth for its Medicare Advantage plans.
Earlier this year, the Biden administration and the Centers for Medicare and Medicaid Services (CMS) said it would cut 2025 payments to Medicare Advantage plans by 0.16 percent, adding financial pressure to CVS Health and other national insurers.
With federal funding levels tightening, several insurers’ 2025 plan menus will shrink, the plans available will be leaner, and insurers, like Aetna, will pull out of some states altogether.
What Does That Mean for Me?
Aetna will cut 2025 Medicare Advantage enrollment by 10% to “prioritize profit margins,” leading them to leave a handful of markets, including New Mexico. CVS Health will discontinue Medicare Advantage enrollments in New Mexico for 2025.
If you have Aetna for your Medicare Advantage Plan in New Mexico, your coverage will continue until the end of 2024. You will need to select a different insurer for your 2025 Medicare Advantage coverage when you enroll.
What are My Next Steps?
First, you need to get the best insurance for you. To ensure you have the right health insurance coverage for your needs, talk with an insurance advocate, who knows what’s going on in the market, understands the products and services available, and has your best interest in mind.
Kirk Begay is a licensed health insurance agent and advocate in New Mexico.