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Aetna Inc agreed to sell its Missouri Medicaid business to WellCare Health Plans Inc as part of its purchase of Coventry Health Care Inc because their combined Missouri businesses had exceeded Medicaid membership limits.  Aetna agreed to acquire Coventry in a $5.7 billion cash and stock deal that will make Aetna one of the largest providers of government-financed health care.  The deal, which it expects to complete in mid-2013, has been under review by U.S. antitrust regulators.

Coventry operates Health Care USA, a Missouri Medicaid plan, with more than 250,000 members.  Combining this with Aetna’s existing Missouri Medicaid plan, Missouri Care, would exceed permissible membership thresholds under Missouri Medicaid contracts.

Wellcare operates Medicare Advantage and state Medicaid plans in several states.  Wellcare recently announced plans to purchase UnitedHealthcare Group Incs (UNH) South Carolina Medicaid business to further strengthen its offerings.