2025 AEP Disruptions: Updates to The Inflation Reduction Act

Do you review plans for people who don't reply with an updated list? i.e. everyone, even the "dis-engaged?"

I will run their comparison as if there are no changes to medications and email it to them. Of course, this is after the initial AEP email and a reminder email. I'll also send out a group reminder email around 30 days left and then one at two weeks and one at one week. If they haven't reached out at any point during this process, it's on them.
 
I'm going to assume she's talking about the cost summary after running it on Search and Save or medicare.gov

I use Search and Save myself. I wish it would list the medication with the tiers only instead of the cost estimate. Like @sshafran, I'm weary of the the 25% estimate amount for a tier 3 medication.

So was wondering if there was something I was missing...
 
I use Search and Save myself. I wish it would list the medication with the tiers only instead of the cost estimate. Like @sshafran, I'm weary of the the 25% estimate amount for a tier 3 medication.

So was wondering if there was something I was missing...

Are you talking about listing only the medication and tier? The first part of the cost summary lists each medication and its tier. Of course, it also lists the cost information in the same section.

What I'd like to see on each cost summary is the basic details of that plan, similar to a Summary of Benefits, but just a chart showing copy/coinsurance percentage for each tier.
 
What I'd like to see on each cost summary is the basic details of that plan, similar to a Summary of Benefits, but just a chart showing copy/coinsurance percentage for each tier.
Agreed. Kind of like how S&S lists the costs by tiers when you do a comparison of 2 plans. Then add the medication name and tier with that page without having any dollar amount estimates on it.
 
Are you talking about listing only the medication and tier? The first part of the cost summary lists each medication and its tier. Of course, it also lists the cost information in the same section.

What I'd like to see on each cost summary is the basic details of that plan, similar to a Summary of Benefits, but just a chart showing copy/coinsurance percentage for each tier.
Around 10/1 I make a quick reference chart of the PDP plans with three essentials:
-Premium
-Deductible (along w/ tier exclusions)
-and the initial coverage 30/90 @ pref

Soon it's memorized.
I do wish S&S had that type of summary somewhere - but a cheat sheet works.
 
I will run their comparison as if there are no changes to medications and email it to them. Of course, this is after the initial AEP email and a reminder email. I'll also send out a group reminder email around 30 days left and then one at two weeks and one at one week. If they haven't reached out at any point during this process, it's on them.
Thank you!
 
What's on the printout?
G and D People:
We are actually confirming lists now and if we don't have it in S&S, getting it updated. Lists will be sent to clients via S&S in early Sept to confirm they are correct.

And then I get to sort them. We actually print them out. Its super fun! The generic only people (assuming no plan change) get an S&S printout via email in early October, with the changes highlighted. (Deductible, premium, new year changes. Its not like 2025 was the first time we had changes). This is usually around 80% of clients. I hire extra help and we sit around a table, typing. Even more fun. BUT. And for the newbies, this is super important: This is part of the sales process. They know how it works prior to the fall.

The other 20% get an email that says "please schedule a call". I don't allow these calls before the 5th, since the systems are still waking up before then. Plus, I already have all the "enroll in Medicare for 1/1" scheduled before then.

For the 20%, I'm going to check Eliquis via the carrier website and then use S&S. That should be about 5% of them. Another 10% are not on Wellcare Value, Smart or BCBSTX. They are already on the list for meetings.

I made a huge push last year to get people on specific plans, anticipating the 2025 drama. (Not that it was hard. Do you want Aetna Choice and CVS at $40 or BCBSTX and Walgreens at $25?)

MAPD: This year, they are all getting the "schedule a call" email. Ugh. One thing you can say about MAPD is that no one moves unless there's a reason. And part of that is that docs only prescribe generic drugs.

But its all a crapshoot until we have plans and premiums.
 
@kgmom219 Thanks for the details, that provides a lot of insight!

I've got a good chunk of clients with WellCare so I'm trying to have my AEP process as smooth as possible for this year.
 
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