Manage Medicare Advantage and ACA with One Expert Partner

Launch, scale, and manage your Medicare Advantage and ACA businesses efficiently with Softheon. Our all-in-one solution brings together plan shopping, enrollment, premium billing and payments - helping you manage your members throughout their entire healthcare journey.

Better member experiences combined with broker management and advanced analytics for plan performance helps your health plans thrive in the competitive government-sponsored market. 

 

Ready to talk MA?

Connect with our experts 

 

You need more than a Medicare Advantage vendor

Softheon is more than just a technology vendor—we are a partner to health plans. Whether you're entering new markets or looking to expand, our experts collaborate closely with you to tailor solutions that meet the unique needs of your health plan and members.

Here's how we make success possible for health plans:

  • Coupling Medicare Advantage and ACA operations to reduce costs and enhance efficiency
  • Integrated partnerships with other trusted vendors to support all back-end operations, from plan filing to claims processing
  • Quick and cost-effective options for regional plans with limited budget and staff

 

 

 

See why Medicare Advantage health plans partner with Softheon

 

Schedule Time to Talk

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One Partner-1
One Partner for One Member Journey

Our platform includes everything you need, from plan selection, eligibility, enrollment, “zero premium” and premium billing, payments, beneficiary, broker communications, broker management, and more. Softheon offers your members an easy and consistent experience across multiple coverage types. Support and retain your members by making the ACA to Medicare transition seamless with one technology partner. 

Plan Performance
Actionable Plan Performance Insights

Advanced analytics, AI, and data integration help you understand your beneficiaries’ behavior and plan performance. The actionable insights you will receive from Softheon's solutions will help you continuously improve your plan design, operations, and health outcomes.

Great Experience
Deliver a Great Experience

We offer self-service portals so brokers, administrators, and beneficiaries get a unified, consistent experience. Combined with plan performance insights, you can improve STAR and CAHPS survey ratings, health outcomes, and ultimately improve plan sustainability.

Get ready to grow in government-sponsored markets:

 

30M

enrollments

100+

licensed carriers

$20B+

premiums processed

Start redefining success in Medicare Advantage today

Whether you're just beginning your journey or seeking your next step, explore our curated content. Learn from the successes and challenges other health plans have experienced in the Medicare Advantage market.

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Top 4 Priorities for Plans New to Medicare Advantage

Softheon shares the results of a “Priorities in Medicare Advantage” survey conducted with ACAP members and Cox HealthPlans. Here are 4 key takeaways from the discussion.

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Challenges and Solutions for APTC Expiration, Medicare Advantage Margins, and More

Medicare Advantage programs are confronting a unique set of challenges. Despite facing tighter financial margins, MA plans are attractive due to their growth potential. Let's discuss how to capitalize on this potential.

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Entering Medicare Advantage as a Regional Health Plan

Susan Sanchez, CIO at Cox HealthPlans, teams up with Softheon to explore how regional health plans can effectively break into the Medicare Advantage market. This session covers strategies to enhance member experiences and reduce operational costs, featuring real-life examples from health plans like yours.

Watch Now

Go beyond table stakes with Softheon's security and compliance

Softheon’s proactive threat management, comprehensive protection strategies, continuous monitoring, and rapid response ensure your health plan remains safe from ever-evolving cyber threats. 

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FIPS 140-2

FISMA-1

FISMA Moderate

HIPPA-1

HIPAA

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NIST 800-53 Rev. 5

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SOC 1 Type 2, Soc 2 Type 2

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CMS MARS-E 2.2

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PCI DSS 4.0.1

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VPAT

Ready to see how Softheon simplifies operations while improving member experiences? Schedule a time to talk.

Schedule Time to Talk