Smoothing on part D is going to be a nightmare

[DonP]

In reality 90% of Mb’s were sacrificed for 10% who take expensive drugs and hit the troop. I think since the golden profit goose of Medicare ending many CO’s will exit the Medicare business . With so many changes yearly CO’s can’t build long term plans .

 

[Special Agent]

In reality 90% of Mb’s were sacrificed for 10% who take expensive drugs and hit the troop. I think since the golden profit goose of Medicare ending many CO’s will exit the Medicare business . With so many changes yearly CO’s can’t build long term plans .

I wouldn't count out the insurance carriers just yet.They have some cost containment wiggle room with the manufacturer discounts and also they have better lawyers than CMS

 

[DonP]

I wouldn't count out the insurance carriers just yet.They have some cost containment wiggle room with the manufacturer discounts and also they have better lawyers than CMS

Im
Not counting out the big 4 . The ones like devoted are private CO’s and need cash infusions from private equity to survive . Devoted can’t keep outbenefitting the giant CO’s like United and humana . Eventually it catches them . They don’t have the scale or funding options to compete long term . There buying business right now

 

[TwoCents]

What's owed for Rx through the Prescription Payment Plan will not transfer from carrier to carrier. The carrier can balance bill, but I believe they're required to offer continued monthly payments. Yes, something else seniors need to keep track of.

A carrier can't deny plan enrollment because money is due for Rx through the Prescription Payment Plan. They can deny someone from (re)joining the Prescription Payment Plan though.

 

[Russ]

I'm a senior and it doesn't sound like a "major" issue.

 

[MedicareWAA]

It’s hard to make a killing in the Pt D market and it’s hard to bankrupt yourself, too. You can lose money but it’s not a devastating loss. The Pt D program’s government reinsurance provision is an important safety net. It also stops a plan from making too much profit. There is a range.

This product has always been important as an enabler of some larger strategy - usually Medigap or their PBM or their group business. Carriers used to be okay not making a ton on Pt D. Now they’re starting to say they’ll be in the business to make money but otherwise it’s not worth the hassle or the distraction or the risk.

Walter