Pdp $$

[Yagents]

Yagents wrote: "If PDP rates are minimum $20+ month, many of those on generics or no drugs are going to start considering the potential costs of PDP LEP vs the premium, And drop their PDP"

Wow, talk about penny-wise and pound-foolish! Wait till somebody needs one of those $16,000 a month cancer drugs and has no coverage. BIG mistake. People who ignore good advice do so at their own peril.

That said, some will want to "move in" with a sibling in another state to create a SEP. If you were their agent, what would you do?

What about those also paying high irmaa on pdp, and can self insure RX? I have a handful already. If pdp premiums are HIGH at $20, and they now have a $0 wellcare plan, I promise u the question will come up if on no drugs or generics. I don't advise it, no agent should.

But, with Part B and med supps premiums rising, people will be looking to cut costs

 

[axeman462]

To add to that if the average price of PDP goes from the current aprox 33.00 to say 50.00 then LEP goes up for future enrollments.Anybody know how this would affect consumers who are currently paying a LEP? I assume they are locked in at the .33 monthly LEP they are at now but don't know for sure.

It's a floating rate.
It changes with the National Average Base Beneficiary Part D Premium every year; whether that be up or down.

 

[DonP]

To add to that if the average price of PDP goes from the current aprox 33.00 to say 50.00 then LEP goes up for future enrollments.Anybody know how this would affect consumers who are currently paying a LEP? I assume they are locked in at the .33 monthly LEP they are at now but don't know for sure.

Leps are not locked in for part d . It's there % lep of the national monthly pdp cost . If pdp's go to $50 a month it's a % of that . Wait till the millions of .50 wellcare plans have to explain how it went to $20-$40. It's why I never flipped my clients chasing price or benefits .

 

[sshafran]

Yagents wrote: "If PDP rates are minimum $20+ month, many of those on generics or no drugs are going to start considering the potential costs of PDP LEP vs the premium, And drop their PDP"

Wow, talk about penny-wise and pound-foolish! Wait till somebody needs one of those $16,000 a month cancer drugs and has no coverage. BIG mistake. People who ignore good advice do so at their own peril.

That said, some will want to "move in" with a sibling in another state to create a SEP. If you were their agent, what would you do?

How many (specific number) clients do you have on a $16,000 per month Cancer drug getting it covered by their PDP, and what are the names of these specific drugs?

 

[Special Agent]

Leps are not locked in for part d . It's there % lep of the national monthly pdp cost . If pdp's go to $50 a month it's a % of that . Wait till the millions of .50 wellcare plans have to explain how it went to $20-$40. It's why I never flipped my clients chasing price or benefits .

So on top of all the other calls from members i expect this AEP there will be calls from members about their increase in LEPs- at least the increase is not in their ANOC!.I have an MA client who bitches every year about her 8.00 LE so she won't be happy.lol

 

[LostDollar]

What about those also paying high irmaa on pdp, and can self insure RX? I have a handful already. If pdp premiums are HIGH at $20, and they now have a $0 wellcare plan, I promise u the question will come up if on no drugs or generics. I don't advise it, no agent should.

But, with Part B and med supps premiums rising, people will be looking to cut costs

As I am sure you know, PDP premiums WITH IRMAA has been discussed before here and there are those who choose to self insure.

I am not those people, so this is just opinion, but I don't think it is (at least to date) the amount of the premium itself but the IRMAA addon amounts and the awareness that as long as they are working with their chosen jobs, those premium additions will continue and increase.

(That is an interesting point of view I never would have been aware of if I had not read posts here.)

 

[kgmom219]

How many (specific number) clients do you have on a $16,000 per month Cancer drug getting it covered by their PDP, and what are the names of these specific drugs?

I have 2 of them and it starts with a K. I think. It's the new leukemia wonder drug.

If it's max IRMAA, I think it's fine. They are making $750K and it's a max of 12 months.

Everyone else? Pay the extra money for CYA.

 

[aheff]

If commissions go to zero, you would not need an SOA because you aren't taking the app. You'll only be asked to provide an SOA in that situation.

I respectfully disagree. Irrelevant if you (plan on) taking an app. You are DISCUSSING Part D; thus, you need a SOA.

 

[kak6407]

Unfortunately I think many of our PDP (especially no meds or all generic meds) clients have got used to the premiums being under $10 for the lowest priced plan the past few years. I went back and looked (CMS has it back to 2007) and noted the lowest priced Part D plan in North Carolina back to 2007. Hopefully we can keep 1 or 2 under $20...but we'll find out in September. See chart below...

 

[Special Agent]

I respectfully disagree. Irrelevant if you (plan on) taking an app. You are DISCUSSING Part D; thus, you need a SOA.

An agent who is appointed with plan and transacts the enrollment is subject to all compliance whether or not plan is commissionable.

If an agent submits application on clients behalf on medicare.gov or the carriers website it is considered fraud and could still technically subject to compliance rules if member has a grievance whether or not agent is appointed.

If agent advises client on how to self enroll at medicare.gov or carrier website then client wonders why they even need an agent in the first place and agent is still technically subject to compliance rules

Dealing with the MAPD clients will not be fun this AEP however they don't often change plans just because of the PDP component of the plan but I would be terrified if i had a huge book of PDP