All plan details released in California

[just-a-client]

Maybe everyone doesn't know - the copy of the "Medicare & You" handbook available at Medicare is always generic. The ones they mail have an appendix listing every single plan (of every type) available to the member at that address. Mine came in the mail today. I didn't get the ANOC yet.

For PDP, in California there are 18 plans, down from 22. Two plans are LIS.

Two plans from Clear Spring are sanctioned, leaving 16 plans.

The handbook lists copays in a really general way, have to read between the lines. For a typical plan, like for Cigna Saver, it only says $0 to $15 copay and/or 17% to 41% coinsurance. I read that as Tier 1 preferred pharmacy $0, Tier 2 standard pharmacy $15, since I think that's how they do it. So, don't really know all the details, like whether Tier 2 preferred is $3, $4, $5 or more. Tier 3 is surely the 17%, and probably it's Tier 4 that is 41%, while Tier 5 is probably 33%. Of course all will be known in 1 week.

Premiums are:

Silverscript Choice 53.60 (down 1.60)

Anthem Blue Cross Plus 164.90 (up 32.20)
Anthem Blue Cross Standard 135.60 (up 35)

Blue Shield Enhanced 183.50 (down 4.90)
Blue Shield Plus 161.70 (up 7.20)

Cigna Assurance 1.80 (LIS, new name, same Plan ID as Cigna Secure) (down 32.70)
Cigna Extra 140.90 (up 35)
Cigna Saver 20.60 (up 4.80)

Humana Basic 110.20 (up 35)
Humana Premier 164.20 (up 35)
Humana Value 94 (new name, same Plan ID as Humana Walmart) (up 35)

UHC Preferred 115.40 (same name but new Plan ID, so I think it's a new plan) (down 6.20 from old Preferred plan)
UHC Saver 124.80 (up 35)

Wellcare Classic 16.80 (LIS) (down 19.10)
Wellcare Value Plus 117.60 (up 35)
Wellcare Value Script 17.40 (up 17)

Based solely on premiums, there are only 2 rational choices for reasonably healthy people: Wellcare Value Script and Cigna Saver.

The formularies will be key, as always.

The BCBS plans here (we have 2 separate BCBS affiliates) have always been outrageously priced, and have low enrollment per q1medicare. Maybe they cover some uncommon drugs that no other plan covers, but perhaps they are simply coasting on name recognition.

 

[bluediamond]

Maybe everyone doesn't know - the copy of the "Medicare & You" handbook available at Medicare is always generic. The ones they mail have an appendix listing every single plan (of every type) available to the member at that address. Mine came in the mail today. I didn't get the ANOC yet.

For PDP, in California there are 18 plans, down from 22. Two plans are LIS.

Two plans from Clear Spring are sanctioned, leaving 16 plans.

The handbook lists copays in a really general way, have to read between the lines. For a typical plan, like for Cigna Saver, it only says $0 to $15 copay and/or 17% to 41% coinsurance. I read that as Tier 1 preferred pharmacy $0, Tier 2 standard pharmacy $15, since I think that's how they do it. So, don't really know all the details, like whether Tier 2 preferred is $3, $4, $5 or more. Tier 3 is surely the 17%, and probably it's Tier 4 that is 41%, while Tier 5 is probably 33%. Of course all will be known in 1 week.

Premiums are:

Silverscript Choice 53.60 (down 1.60)

Anthem Blue Cross Plus 164.90 (up 32.20)
Anthem Blue Cross Standard 135.60 (up 35)

Blue Shield Enhanced 183.50 (down 4.90)
Blue Shield Plus 161.70 (up 7.20)

Cigna Assurance 1.80 (LIS, new name, same Plan ID as Cigna Secure) (down 32.70)
Cigna Extra 140.90 (up 35)
Cigna Saver 20.60 (up 4.80)

Humana Basic 110.20 (up 35)
Humana Premier 164.20 (up 35)
Humana Value 94 (new name, same Plan ID as Humana Walmart) (up 35)

UHC Preferred 115.40 (same name but new Plan ID, so I think it's a new plan) (down 6.20 from old Preferred plan)
UHC Saver 124.80 (up 35)

Wellcare Classic 16.80 (LIS) (down 19.10)
Wellcare Value Plus 117.60 (up 35)
Wellcare Value Script 17.40 (up 17)

Based solely on premiums, there are only 2 rational choices for reasonably healthy people: Wellcare Value Script and Cigna Saver.

The formularies will be key, as always.

The BCBS plans here (we have 2 separate BCBS affiliates) have always been outrageously priced, and have low enrollment per q1medicare. Maybe they cover some uncommon drugs that no other plan covers, but perhaps they are simply coasting on name recognition.

They were also in my Medicare and You for 2025 here in Florida.

 

[InsuranceGuy29]

Thank God for that supposed "Inflation Reduction Act." Working well! We did it, Joe!!

Jesus Christ, those premiums are absolutely outrageous. They should've called it the "Inflating Inflation Act."

 

[just-a-client]

The premiums here weren't great to begin with.

When I started on Medicare a 7 years go there were a number of plans reasonably priced in my region. Silverscript, Humana Walmart, and others were under $30, many more under $40. The most popular plan, I believe, was Silverscript choice, which was $29.90 with a $0 deductible, the only plan with no deductible at anywhere near that price. But it didn't have terrific copays, and it up-tiered some drugs. Terrific coverage though for people with minimal drug use.

PDP prices sure have exploded over the years. Watching the Silverscript, and Walmart and Walgreens branded plans go up in price (and now they've all disappeared) was something I never expected.

 

[just-a-client]

Found a pattern in the Wellcare First Look: in the states with non-zero premiums, Wellcare has lowered Tier 4 coinsurance.

In California, Tier 4 is dropping from 50% to 35%. In NYS it will be 34%.

It's higher in all the other states with the zero premium. For example, Montana: 49%, Colorado: 40%.

Perhaps they are experimenting to see if the market wants the cheaper Tier 4 or the lower premium, and they are able to set up an easy experiment - a few large states vs. most of the rest of the country.