Prime Therapeutics' new GoEnroll solution simplifies Medicare enrollment while improving the member experience

Choosing and enrolling in Medicare coverage can be confusing for members and operationally complex for health plans. Prime Therapeutics (Prime) is owned by independent, not-for-profit Blue Cross and Blue Shield plans and understands those challenges well.

To help address this, Prime developed GoEnroll™, a digital end-to-end platform designed to simplify enrollment, improve the patient experience and reduce administrative burden for health plans. The platform aligns with applicable Centers for Medicare and Medicaid Services (CMS) Medicare enrollment requirements and can be deployed "off-the-shelf," enabling health plan sponsors to effectively navigate enrollment rules, processes and bid timelines.

"GoEnroll is another example of how Prime is helping to both simplify Medicare enrollment for health plan sponsors and create a better experience for members," said Alex Borges, vice president, Medicare & Managed Medicaid at Prime. "Now, more than ever, we are playing a critical role in working with clients to provide innovative solutions that solve for some of the biggest challenges in healthcare, with a focus on lowering overall costs and improving clinical and quality outcomes."

Built to reduce confusion for enrollees and plan sponsors

GoEnroll streamlines Medicare enrollment for health plan sponsors and patients by bringing core functions into one platform, including:

• Application intake from multiple sources, including enrollees, brokers, employers and others
• Direct integration with the CMS Online Enrollment Center to help efficiently process applications
• Enrollment processing, premium billing and financial reconciliation
• Daily enrollment reporting for health plans and brokers
• An enrollee self-service portal for premium payments, history information and more

The platform is designed to give plan sponsors greater options, supporting customized or complete services aligned with CMS compliance. GoEnroll integrates with Prime's broader Medicare services and operational capabilities, meaning health plans can reduce handoffs, streamline administration and create a more seamless experience for members. GoEnroll is currently available for health plan sponsors that offer Medicare Prescription Drug Plan, Medicare Advantage Prescription Drug and Employer Group Waiver Plans.

Prime programs close gaps in care and drive savings for Medicare patients and plan sponsors

GoEnroll is part of a comprehensive suite of Prime's Medicare solutions that have delivered measurable savings for patients and health plans, while helping drive improved health outcomes through high-touch clinical support.

GuidedHealth^® identifies opportunities to improve drug safety and medication adherence to help close gaps in patient care. With approximately 2 million Medicare enrollees on the program in 2025, the solution has resolved more than 2.2 million clinical opportunities - saving a net $11.07 per member per month (PMPM) - through drug savings and medical cost avoidance.

HighTouchRx^® is Prime's clinical intervention program that uses integrated data to identify patients with high prescription costs and offers potential alternate therapies that can lower costs for the patient, as well as health plans and employers. In 2025, HighTouchRx delivered $25 million in drug therapy savings across 1.35 million Medicare enrollees - or $1.54 PMPM - through prescriber outreach to mitigate duplicate therapies or identify lower-cost care options.

Look for more from Prime on Medicare solutions with Stars & Bid coming up in November.