I dug deep Into all components of the plans in many states . I looked at copays,rx deductibles and tier payments, and benefits . My final conclusion is regular current mapd plans are far worse in 2025 than 2024. Its seems Uhc has come up with like new plans in most markets . For instance I’ve noticed they’ve basically taken dental off most of their current 2024 mapd plans. They only cover basic cleanings and X-rays it appears . But they cover no comprehensive . It seems the new plans cover full dental but all those plans have $590 deductible and 25% copays on rx’s . None of us know the drug tiers yet or what drugs covered in 2025. The dual plans appear to be similiar as last yrs plans . It appears with duals having the most profit margin by far there leaving those alone to keep market share . We haven’t seen Aetna’s,Humana’s or WellCare’s detailed plans yet. In a nutshell there will be a lot of movement in 2025 as all have said.
I Did detailed analysis of Uhc’s mapd .
- Thread starter DonP
- Start date
- Staff
- #2
- 1,589
I am curious what else you can share on the dental changes.
MidwestMedicare
New Member
- 12
The biggest changes I see in the Milwaukee market is on the PPO plans. The HMO plans (which are substantially more popular here due to the strong network in this area) barely changed outside of introducing a drug deductible for T3-T5. My guess this is largely being brought on by changes to their Star rating last year (PPO went from 4.5 to 3.5 and HMO stayed steady at 4.5). My clients that are in the more rural parts of the state will be effected a lot more given that a much higher percentage of them are on the PPO products. Their MA only Patriot plan took a huge hit as well. 
- Thread starter
- #4
No company has disclosed their summary of benefits yet to see more detailed analysis of what’s really covered .But it looks like in many existing plans only covering cleanings and X-rays . Most of those plans you can buy a rider for full dental . I know on Cigna’s dental during certification it looked like that had 50% copays on major benefits .
Special Agent
Guru
- 380
The biggest changes I see in the Milwaukee market is on the PPO plans. The HMO plans (which are substantially more popular here due to the strong network in this area) barely changed outside of introducing a drug deductible for T3-T5. My guess this is largely being brought on by changes to their Star rating last year (PPO went from 4.5 to 3.5 and HMO stayed steady at 4.5). My clients that are in the more rural parts of the state will be effected a lot more given that a much higher percentage of them are on the PPO products. Their MA only Patriot plan took a huge hit as well.
In the florida and other markets they are trying to get people off the patriot RPPO and get them on the patriot LPPO where they have increased the give back to 100.00
In florida i would have moved many more of my uhc ppo to hmo if the hmo didn't have a 6.00 tier 2 copay where the ppo was 0.in 2025 the hmo has 0 for tier 1 and 2
MedStar
New Member
- 13
How did you go about gathering your data? Plan Summary of Benefits? Medicare.gov? Quoting tools?
- Thread starter
- #7
No Jarvis shows the basics of every plan in all states . It’s not extensive deep dive but it shows plenty to formulate things
straightnochaser
Guru
- 853
So you "dug deep" by looking at the "basics" on every plan??
MedStar
New Member
- 13
The OP specifically says "detailed" in the title, actually posts that it is NOT a deep dive.
- Thread starter
- #10
Deep dive into the basic benefits . Co pays,Co ins,food card .dental amount ,(does it cover preventative or comprehensive ),otc . Deeep dive enough to know that overall most things being cut big . And all this is before we even know rx forumalaries .
Similar threads
