just-a-client
Expert
- 28
The plans with full deductible on all tiers are really designed for people with Extra Help who may also be dual eligibles, and Extra Help pays for the deductible, lowers all the copays, and reduces the premium, sometimes to $0.
These plans are Basic/Actuarially Equivalent Standard plans, not Enhanced Alternative Plans, so they are more similar to the Medicare Defined Standard (which is full deductible, then 25% across the board in the Initial phase).
What Aetna Silverscript is doing for 2025 is only offer the Basic plan, cancelling the Enhanced plans - hence, their only plan is the one with the full deductible. That means they are offering the one plan they have had where Medicare pays the deductible, and the copays are just nominal amounts, and the premiums are discounted. I wouldn't be surprised if those plans are the most profitable for them. For California, the premium for Silverscript Choice will be $44.90 - but the LIS (subsidy) is $50.99, which more than covers the premium entirely, so that the enrollee premium for people getting Extra Help actually turns out to be -- $0!
For anyone not getting Extra Help, I suppose these plans can still be worthwhile just like any other plan, even with the high deductible, if the formulary has the best coverage or the preferred pharmacy choices work out better for them. But I don't think these plans are primarily targeted to the general public.
