Jefferson Health Plans had big gains in Medicare Advantage during open enrollment last year
Jefferson remained in sixth place in Southeastern Pennsylvania behind leader Independence Blue Cross, Aetna, UnitedHealthcare, Humana, and Cigna, despite strong growth.
Jefferson Health Plans added nearly 12,000 new customers to its Medicare Advantage plans during the open enrollment period for coverage this year, the biggest annual gain ever for the insurance arm of Thomas Jefferson University.
About half of Jefferson’s enrollment gains were in Philadelphia, Montgomery, and Bucks Counties. Still, Jefferson remained the sixth largest provider of private Medicare plans in Southeastern Pennsylvania. The Inquirer compared February 2025 with last month.
Philadelphia-based Independence Blue Cross was leader, with one-third of the region’s 383,000 Medicare Advantage customers. National companies Aetna, UnitedHealthcare, Humana, and Cigna occupied the next four spots.
“This was the strongest Medicare Advantage enrollment period in Jefferson Health Plans’ history,” Jefferson Health Plans president Krista Hoglund said in an email.
“That level of growth signals a clear gap in the market for coverage that is anchored in the local community, easier to use, and closely connected with the doctors and hospitals they know and trust,” she said.
New Jersey has been a harder market for Jefferson. Enrollment more than doubled this year, but the eight counties in South Jersey where Jefferson sells plans still account for less than 10% of its members.
Jefferson gained about 2,400 members in Lehigh Valley counties served by Lehigh Valley Health Network, which Jefferson acquired in 2024. Jefferson’s ownership of an insurer was a key reason why Lehigh Valley chose to become part of Jefferson, health system officials said at the time.
Jefferson’s gains in the Lehigh Valley came amid a contract dispute with United HealthCare, leading to LVHN going out of network in January for UnitedHealthcare Medicare Advantage plans. Jefferson had warned in October that the contract was expected to end.
United said then that the timing of the warning during the Medicare Advantage open enrollment period looked like a “negotiating tactic” that could lead United customers to choose other plans.
The two Pennsylvania counties where United had the biggest percentage declines were Lehigh and Northampton, where LVHN has substantial operations.
The biggest gains, however, went to Capital Blue Cross, of Harrisburg.