PDP's going Sky-high in 2024? National Base Beneficiary Premium $64.28

[sman]

2024 Aetna SmartSaver ANOC (Georgia). Good news, bad news edition. Premium doubles, but deductible cut in half tiers 2 - 5. Preferred tier 1 copay $0, tier 2 $5, tier 3 24%, tier 4 24%, tier 5 29%. Standard tier 1 $8, tier 2 $12, tier 3 24%, tier 4 50%, tier 5 29%.

Can't imagine the WellCare plan isn't going to really eat into the SS market share. Premium of $0.50. Much higher deductible, but it doesn't apply to Tiers 1 & 2. Copay for Tier 1 will be $0 and Tier 2 is $5. Again, this is dependent on the formulary.

Also, Humana Walmart plan will be $50.60 per month here in Georgia. They are likely to see a mass exodus as well.

 

[somarco]

Can't imagine the WellCare plan isn't going to really eat into the SS market share. Premium of $0.50. Much higher deductible, but it doesn't apply to Tiers 1 & 2. Copay for Tier 1 will be $0 and Tier 2 is $5. Again, this is dependent on the formulary.

Also, Humana Walmart plan will be $50.60 per month here in Georgia. They are likely to see a mass exodus as well.

At this point I see a big win for WC . . . at least until they decide sniping at the agent enrolled PDP business is easy pickings and pitching their MAPD

 

[Truce]

From Kaiser:

"For 2023, Medicare’s actuaries estimate that Part D plans will receive direct subsidy payments averaging $106 per enrollee overall, $2,855 for enrollees receiving the LIS, and $1,140 in reinsurance payments for very high-cost enrollees; employers are expected to receive, on average, $557 for retirees in employer-subsidy plans. Part D plans also receive additional risk-adjusted payments based on the health status of their enrollees, and plans’ potential total losses or gains are limited by risk-sharing arrangements with the federal government (“risk corridors”)."

My question:

If most carriers put through big PDP increases before facing a 6% cap on (average) premiums next year, how can Wellcare's strategy be that far in the other direction? Insurance is not a business where one carrier is usually so different than the others. When I've seen this in the past, it usually doesn't work out well for the carrier or the clients.

 

[DS4]

There is no way WellCare is prepared for a tsunami of Part D business this AEP.

 

[sman]

There is no way WellCare is prepared for a tsunami of Part D business this AEP.

Agreed

 

[Russ]

Humana Walmart PDP in Florida goes from $36.50 per month to $46 per month, but they have lowered the copays on tier 1 (from $1 to $0) and tier 2 (from $2 to $1).

Not bad, but then again Wellcare is hard to beat at $0 a month.

 

[kgmom219]

My Two Cents on 2024 AEP

1. Wellcare is going to get hammered on enrollment. There is clearly a reason and my best guess is that its to sell off their Part D/MAPD and its pretty clear that MOO is buying. From a customer service standpoint, they've got problems. We all know it. How you decide to handle it with a FREE (come at me, CMS) Part D plan is up to the agent.
2. The large MAPD carriers (UHC, Humana, Aetna) are not only increasing (doubling in some cases) their premiums, it will significantly impact the pricing disparity on meds between Part D and MAPD. And if you think this isn't all about increasing MAPD enrollment, I've got a bridge to sell you.
3. BCBSTX/HCSC are hiking the premiums but still in play. Most likely because they have been slow in the Part D arena since 2006.
4. I'm also expecting tighter formularies, where current Tier 2/no deductible drugs move to Tier 3.

I've played this game before, boys. Its a great year to really increase your headcount. Mass confusion, mass change equals more people who need and are looking for help. Chaos is good for business.

Let's gooooooo!

 

[somarco]

Someone, may have been WC, got in dutch with CMS because they were overwhelmed and "late" issuing PDP policies a few years ago. Some clients did not get their enrollment package until Feb or maybe later.

CMS sanctioned the carrier and they had to sit on the bench for a while.

Could happen again

 

[Russ]

What I don't like is the lower premium PDP's going to a coinsurance on tier 3. You have to purchase the more expensive plans to eliminate the tier 3 coinsurance and have a copay. It's great if you just take generics but tier 3 and up is not good on lower premium plans. That's a problem.

 

[AgentGeneral]

Wow, 13 pages of fun. Couldn't readit all. This is definitely good for business. Time to get ready. The exodus will continue.

Just like any time a carrier/carriers want to get rid of a plan or plans, they hike premiums, create confusion and get what they want. Push the people off by using pain in the pocket book. Dangle a few carrots (freebies) to make it happen faster. I think in 5 yrs MAPD will be predominant everywhere if it's not already (It is in my area) and their will be more premiums on that. First things first, get everyone moved over by the jacking and messing, then start tweaking the MAPD premiums and lowering the freebies. It's a process that's been well underway for awhile. This is the back end of it. IMO. We all know this though, or at least the people who have been in any insurance market, esp this one.