AultCare to Stop Offering Individual PrimeTime Medicare Advantage Plans in Tuscarawas County

AultCare will not offer individual PrimeTime Health Plan Medicare Advantage coverage to Tuscarawas County residents next year, the Canton-based insurer has told affected enrollees by mail. Yahoo published the notice. AultCare is a provider-sponsored, Ohio-based health insurer and third-party administrator affiliated with Aultman Hospital, according to akta.pro company records.

AultCare's PrimeTime Exit in Tuscarawas

AultCare, part of the larger Aultman Health System, mailed notices to the affected PrimeTime Health Plan enrollees. PrimeTime employer group plans in Tuscarawas County will be continued. The nonprofit insurer did not share the number of people affected.

AultCare offers PrimeTime Health Plan as its Medicare Advantage option and PrimeTime Choices as a Medicare supplement or Medigap plan. In a statement, the health system said: "AultCare's PrimeTime Health Plan has been reevaluating its Medicare Advantage offerings because of changes in the market, changes in CMS reimbursement and rising medical expenses, much like many other insurance plans across the nation."

The statement continued: "This allows us to focus where we can provide the strongest value, highest quality and most sustainable Medicare Advantage offerings for our members." AultCare said it sent letters to impacted enrollees to help them evaluate options and make coverage decisions for 2027 during the Annual Enrollment Period, which is going on now.

Chelsea Youngman, an independent insurance agent focused on health care and Medicare in the region, said she has a number of Tuscarawas County clients on PrimeTime and evaluates each person's situation and options with them. "Obviously, they're kind of frustrated and upset," she said. Youngman said she is not aware of any other insurance providers dropping clients in Tuscarawas County this year but said it is not "uncommon" for Medicare Advantage options to change, particularly in rural areas.

Patricia Doby, an agent for 35 years at the independent Nelson Insurance | SeibertKeck Agency in New Philadelphia, currently writes for 13 carriers with Medicare Advantage plans. Doby, who has 160 or more clients on AultCare's PrimeTime, said in an email that many feel "blindsided" by the decision and that sub-par reimbursement in Tuscarawas County is a factor in the service area reduction. "We don't want them to panic," Youngman said. "We're here to help them through the situation."

AultCare's PrimeTime History and Reach

AultCare launched PrimeTime Health Plan Medicare Advantage after receiving CMS approval in 1997, expanding into the Medicare segment and becoming a 4.5-star rated plan, according to akta.pro company records. The same records describe AultCare as serving 430,000+ members annually through claims processing, with a culture of over 500 employees. AultCare was founded in 1984 and is headquartered in Canton.

2027 Enrollment Decisions for PrimeTime Members

AultCare said the letters are meant to help impacted enrollees evaluate their options and make coverage decisions for 2027 during the Annual Enrollment Period, which is going on now. Youngman encouraged anyone affected to reach out to PrimeTime plan representatives or a local insurance agent.