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- #131
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That 6% is for EXISTNG plans. So just shut down the plan and start up a new plan. No worries.....it's raining money for the drug companies....
PDP's going Sky-high in 2024? National Base Beneficiary Premium $64.28
- Thread starter Duaine
- Start date
That 6% is for EXISTNG plans. So just shut down the plan and start up a new plan. No worries.....it's raining money for the drug companies....
No it's the pbm's that are making and controlling the $$$$$That 6% is for EXISTNG plans. So just shut down the plan and start up a new plan. No worries.....it's raining money for the drug companies....
It’s not 6%.
I spent 2 hours yesterday on a zoom with people and we were combing through the CMS actuary memos trying to make the rules into a consumer friendly blog post. We took a break because we all needed to start drinking.
But it’s not 6%. It’s 6% of the basic plan (D and MAPD combined) to create a basic beneficiary premium. Less than 25% are enrolled in this type of plan. (Think SS Smart. Tiny formulary, max deductible). Average Basic Plan for 2024 was $33. Or $39. (I’m not getting my notes out)
75% are enrolled in “supplementary plans”. The carriers bid those. Then the actual premium is based on the average, with the difference of the BBP.
So if you are over the average, your bid is decreased by the difference of the average and BBP. If carriers bid is under the average, then it’s increased by the difference of the average plus the BBP.
Then the 6% is based on the BBP plus the Supplemental average
I *think* this is right. I’ll tweak it tomorrow.
But it’s 6%…in some dimension of a govt actuarial nightmare
I spent 2 hours yesterday on a zoom with people and we were combing through the CMS actuary memos trying to make the rules into a consumer friendly blog post. We took a break because we all needed to start drinking.
But it’s not 6%. It’s 6% of the basic plan (D and MAPD combined) to create a basic beneficiary premium. Less than 25% are enrolled in this type of plan. (Think SS Smart. Tiny formulary, max deductible). Average Basic Plan for 2024 was $33. Or $39. (I’m not getting my notes out)
75% are enrolled in “supplementary plans”. The carriers bid those. Then the actual premium is based on the average, with the difference of the BBP.
So if you are over the average, your bid is decreased by the difference of the average and BBP. If carriers bid is under the average, then it’s increased by the difference of the average plus the BBP.
Then the 6% is based on the BBP plus the Supplemental average
I *think* this is right. I’ll tweak it tomorrow.
But it’s 6%…in some dimension of a govt actuarial nightmare
AgentGeneral
Guru
- 281
This was mildly interesting to me, might be for someone else on here. And sure, just get a personal loan so you can afford your overpriced Eliquis.
https://www.foxbusiness.com/personal-finance/medicare-part-d-drug-price-increase-aarp
https://www.foxbusiness.com/personal-finance/medicare-part-d-drug-price-increase-aarp
straightnochaser
Guru
- 549
But remember y'all... allowing Medicare to negotiate drug prices is socialism. Can't have that..
I'll piggyback off of this to hopefully make it a bit more clear.
There are Basic plans (the ones that receive the Auto-Assigned beneficiaries from Medicare,, think Dual Eligibles) and there are Enhanced plans (the plans with super low premiums and the plans with extra gap coverage).
The Enhanced plans have 2 parts to their premium, the Base amount and the Supplemental amount. The Base piece cannot increase by more than 6% but the Supplemental amount can be increased(or decreased) by the plan sponsor by as much as they want, as long as they meet all actuarial rules associated with PDP guidance.
My point, the $0.00 premium plan CAN increase in 2025 because the premium has 2 components: Base and Supplemental. Base: $0.00 x 6% + Supplemental: whatever the plan wants to charge. Hope this is helpful
Refreshing . . . NOT!
The folks in DC will never learn. Luxury tax on the rich in the 90's was supposed to bring in millions in new tax revenue. Companies that sold luxury items like private airplanes and yachts found a way to bypass the tax and DC ended up repealing the law 2 years after implementation.
ACA/Obamacare was promoted as "making healthcare more affordable", increasing competition which would lower premiums, all while "not adding one dime to the deficit", and of course "if you like your doctor you can keep your doctor, and if you like your plan you can keep it".
Of course none of this became true but we still have that albatross.
Both political parties can share the blame.
Point is, just when the Congress critters think they have a way to trick the electorate into believing they are getting something good from DC their plans are thwarted by folks who understand how the REAL world works.
I would like to think IRA will be repealed, at least the part that INCREASES drug costs for seniors but it may not happen even though the ANOCS are exposing the truth behind IRA and next year is an election year . . .
Hey all, newbie here, heard an agent on a podcast say they offer MS clients a DIY guide on PDPs to choose and manage their own PDP enrollment, AND/OR they offer a paid service to conduct the PDP enrollment for a one-time fee ($149 for one, $249 for a couple as they age in). Anyone done this? Allowed? Thanks.
straightnochaser
Guru
- 549
Don't think that's allowed and why on earth would anyone even pay that smh
