SMS marketing Zoom Overcoming Medicare Disruption Brought on by the Inflation Reduction Act.

[DonP]

Like I've said 30 times the name of the game for agents with big books is retention, retention . Forget growing your book much this aep . You'll be spending 12 hrs a day , 7 days a week with clients . But that still doesn't mean they don't move aep and oep . Personally i think oep will be much tougher than aep . Once the reality hits people how different their plan is in 2025 they'll be very open to moving plans . Even if the plan they move to isn't better they can be tricked easily . The calls will be nonstop oep . You can stick you head in the sand or prepare .

 

[InsuranceGuy29]

If you think Dems are "demons" why don't you do something about it?..

You use language like that about other people based on political beliefs is reminiscent of Georges Ruggio (you'll probably need to look him up) and really just shows who the real problem is (you)

I do quite a lot about it on an activist level. And seeing the objective active destruction of this country by a party of one doesn't make me the "problem," but I do love the projection.

 

[kgmom219]

Everybody chill out.

I'm running scenarios now using current client lists. Once I get it "blessed" by people smarter than me, I will share.

The $2K is based on pharmacy cost OR patient cost, whichever is less.

Standalone Part D

People currently hitting the donut hole but not coverage gap are breaking even over 12 months. This assumes a doubling of their current premium. Unless on WellCare Value or SS Smart, I'm using $50/month for them.

People hitting catastrophic are going to be dancing in the streets. Again, I'm doubling the premium

People on 2 generic drugs??? I HAVE NO CLUE. That will all hinge on WellCare Value and SS Smart premiums.

MAPD
HMO-They will mostly keep their $0 drug deductible, but increase copays, cut the extras.

PPO-These people are going to get killed. They will have a "new" Part D deductible.

The plans are all going to look like SS Smart does now. A tiny list of no deductible/ copay drugs. Everything else will apply to deductible.

And anyone who recommends the Prepayment plan? You have my sympathy.

 

[DonP]

Everybody chill out.

I'm running scenarios now using current client lists. Once I get it "blessed" by people smarter than me, I will share.

The $2K is based on pharmacy cost OR patient cost, whichever is less.

Standalone Part D

People currently hitting the donut hole but not coverage gap are breaking even over 12 months. This assumes a doubling of their current premium. Unless on WellCare Value or SS Smart, I'm using $50/month for them.

People hitting catastrophic are going to be dancing in the streets. Again, I'm doubling the premium

People on 2 generic drugs??? I HAVE NO CLUE. That will all hinge on WellCare Value and SS Smart premiums.

MAPD
HMO-They will mostly keep their $0 drug deductible, but increase copays, cut the extras.

PPO-These people are going to get killed. They will have a "new" Part D deductible.

The plans are all going to look like SS Smart does now. A tiny list of no deductible/ copay drugs. Everything else will apply to deductible.

And anyone who recommends the Prepayment plan? You have my sympathy.

Unfortunately the guy making $30-$60 k in retirement doesn't have $590 on Jan 1st to meet his deductible. I guess it comes down to people got spoiled with little out of pocket on most drugs . Here's what I liken it to . It's like a $3500 moop with $150 office visits amd $1500 a night in the hospital . Sure the $3500 moop sounds incredible just like the $2000 troop rx . But the CO's are going to damm well make sure 80% hit there $3500 moop like they'll make them hit the $2000 rx troop . 90% of these people had little oop . Now they must pay for the 10% that crush the carriers

 

[Special Agent]

Unfortunately the guy making $30-$60 k in retirement doesn't have $590 on Jan 1st to meet his deductible. I guess it comes down to people got spoiled with little out of pocket on most drugs . Here's what I liken it to . It's like a $3500 moop with $150 office visits amd $1500 a night in the hospital . Sure the $3500 moop sounds incredible just like the $2000 troop rx . But the CO's are going to damm well make sure 80% hit there $3500 moop like they'll make them hit the $2000 rx troop . 90% of these people had little oop . Now they must pay for the 10% that crush the carriers

Don i don't think the carriers will want members to hit the 2000 part d troop because they have to pay 60% of those cost after that

 

[DonP]

Don i don't think the carriers will want members to hit the 2000 part d troop because they have to pay 60% of those cost after that

Correct but they know the exact # of people take bs drugs that were zero . Remember a lot of low cost drugs will have copays now were they never spent much before . They still want to suck that $2k from them

 

[kgmom219]

Unfortunately the guy making $30-$60 k in retirement doesn't have $590 on Jan 1st to meet his deductible. I guess it comes down to people got spoiled with little out of pocket on most drugs . Here's what I liken it to . It's like a $3500 moop with $150 office visits amd $1500 a night in the hospital . Sure the $3500 moop sounds incredible just like the $2000 troop rx . But the CO's are going to damm well make sure 80% hit there $3500 moop like they'll make them hit the $2000 rx troop . 90% of these people had little oop . Now they must pay for the 10% that crush the carriers

Option 1- move to HMO. Most people aren't going OON, anyway. They can change back next year

Option 2-Enroll in the prepayment program and pray that it works

Option 3-Put PPO "new to Part D deductible" people at the front of the line. They need a 90 day supply ASAP on Oct 1. Refill between Christmas and Jan1. Start buying $100 gift cards monthly at the pharmacy, on April 1 (when the next 90 day supply is due) they should have $600 in gift cards. Obviously this requires the refills to work.

But I think most of them will move to the HMO. No deductible and keep the extras. The divide between HMO and PPO extras will be even bigger next year

 

[DonP]

Option 1- move to HMO. Most people aren't going OON, anyway. They can change back next year

Option 2-Enroll in the prepayment program and pray that it works

Option 3-Put PPO "new to Part D deductible" people at the front of the line. They need a 90 day supply ASAP on Oct 1. Refill between Christmas and Jan1. Start buying $100 gift cards monthly at the pharmacy, on April 1 (when the next 90 day supply is due) they should have $600 in gift cards. Obviously this requires the refills to work.

But I think most of them will move to the HMO. No deductible and keep the extras. The divide between HMO and PPO extras will be even bigger next year

What makes you think the HMO's won't have part d deductibles ? CO's are going to manipulate or exit plans that were very popular and they lost money on . There going to jigger part d formularies making it difficult for the person with 8 plus rx's to get them all covered .Joe Biden didn't understand carriers never lose . When you put more of the cost on the carriers and drug CO's they'll simply pass it on to the member .

 

[vic120]

What makes you think the HMO's won't have part d deductibles ? CO's are going to manipulate or exit plans that were very popular and they lost money on . There going to jigger part d formularies making it difficult for the person with 8 plus rx's to get them all covered .Joe Biden didn't understand carriers never lose . When you put more of the cost on the carriers and drug CO's they'll simply pass it on to the member .

Wo wait, you don't think Joe Biden is actually looking over these bills and making decisions by his self, do you?

 

[Bob L]

Medicare pays 80% during catastrophic phase in 2024.

I was referring to '25, the year under discussion. Should have been more specific! Medicare pays 20% next year in catastrophic phase.