UHC 2025 First Looks....

[Special Agent]

The HMO-POS in some counties in the panhandle has an $8 a month benefit on part B premiums.

i do most my UHC in n florida and they came out with new flex hmo with 350 per quarter card they can use on any medicare benefit 6700 moop.I wish they didn't come out with this plan because i have a lot of people on the UHC HMO POS that has been incredibly sticky so i hope not too many will want to switch

 

[DonP]

We can see nothing on the dsnp's . It appears they have divided up the dsnp's from last yr . Partial dnsps qualified for full food card ,dental benefits the past few yrs . It appears they've moved those to a new plan . Nothings concrete unti the books come out at end of Jan . last yr they had to come back and increase some benefits. But rx's look very similiar to last yr with $295 type tiers 3-5 and 0/12/47/100 copays . I see no %'s

 

[Special Agent]

We can see nothing on the dsnp's . It appears they have divided up the dsnp's from last yr . Partial dnsps qualified for full food card ,dental benefits the past few yrs . It appears they've moved those to a new plan . Nothings concrete unti the books come out at end of Jan . last yr they had to come back and increase some benefits. But rx's look very similiar to last yr with $295 type tiers 3-5 and 0/12/47/100 copays . I see no %'s

the UHC patriot ppo w/o rx rebate went up to 100 from 55 which is a surprise.anybody seen what the aetna eagle ppo rebate will be in 2025 in florida?

 

[Special Agent]

We can see nothing on the dsnp's . It appears they have divided up the dsnp's from last yr . Partial dnsps qualified for full food card ,dental benefits the past few yrs . It appears they've moved those to a new plan . Nothings concrete unti the books come out at end of Jan . last yr they had to come back and increase some benefits. But rx's look very similiar to last yr with $295 type tiers 3-5 and 0/12/47/100 copays . I see no %'s

I just looked at the uhc snp again for fl looks like a new ppo and hmo that says for full medicaid peeps whereas the existing snp hmo and say medicare and medicaid.I don't think these they are doing anything to help the spend down for partials its just the new plans for full medicaid only which may be mostly so they can change plans monthly using the fully integrated SEP in 2025 but whatever it is it's going to cause extra work and make my book of business more vulnerable to cold calling mofos who say they are calling from UHC to help them with their plan.

 

[GoPokes]

TX 2025 has the drug deductibles, but still showing OTC as covered.

Interesting-Hospital Copay is "Coming Soon"

They will release the missing stuff shortly after August 15, that's when the final CMS Rebid is submitted/decided.

 

[DonP]

I just looked at the uhc snp again for fl looks like a new ppo and hmo that says for full medicaid peeps whereas the existing snp hmo and say medicare and medicaid.I don't think these they are doing anything to help the spend down for partials its just the new plans for full medicaid only which may be mostly so they can change plans monthly using the fully integrated SEP in 2025 but whatever it is it's going to cause extra work and make my book of business more vulnerable to cold calling mofos who say they are calling from UHC to help them with their plan.

Bingo !!!! Means all those qmb's and partials slmb , QI etc that you had on full Medicaid plans ( Qmb plus and Fdbe ) will stay on the same plan but there benefits will be cut big . The new dsnps ( Qmb plus and Fdbe ) will have the same benefits or near as this yr . Will United move the full Medicaid to the new better plans ? Hell no . Means call centers and United will be picking those off like turkeys . I thought duals were safe . Impossible for me to move all these people in 7 weeks

 

[Special Agent]

Bingo !!!! Means all those qmb's and partials slmb , QI etc that you had on full Medicaid plans ( Qmb plus and Fdbe ) will stay on the same plan but there benefits will be cut big . The new dsnps ( Qmb plus and Fdbe ) will have the same benefits or near as this yr . Will United move the full Medicaid to the new better plans ? Hell no . Means call centers and United will be picking those off like turkeys . I thought duals were safe . Impossible for me to move all these people in 7 weeks

I believe it is only FM not the QMB + we have to worry about.Might also have to do with some additional medicaid wrap benefits that the FM get like unlimited transportation beyond the 72 one way trips that QMBs ,SLMBs get.Just spitballing ere but if i had to guess i would say about 20% of my DSNP have FM.I am sure that number is available somewhere.

 

[DonP]

I believe it is only FM not the QMB + we have to worry about.Might also have to do with some additional medicaid wrap benefits that the FM get like unlimited transportation beyond the 72 one way trips that QMBs ,SLMBs get.Just spitballing ere but if i had to guess i would say about 20% of my DSNP have FM.I am sure that number is available somewhere.

Correct . Fdbe , Qmb plus and slmb plus full Medicaid . In my state I've never seen Qmb plus or slmb plus .Id say 45% of my state is Qmb and 45% partial ( slmb , qi ) . Means all those qmb's who have full medical cost sharing will be screwed be lumped in on a lower benefit plan with partials

 

[Special Agent]

Correct . Fdbe , Qmb plus and slmb plus full Medicaid . In my state I've never seen Qmb plus or slmb plus .Id say 45% of my state is Qmb and 45% partial ( slmb , qi ) . Means all those qmb's who have full medical cost sharing will be screwed be lumped in on a lower benefit plan with partials

just got some new information for Florida.Nobody on current UHC DSNP will be migrated and full duals and partials can remain on current plan and the extra benefits will remain basically the same.There is speculations that partials on current DSNP may get some help with spend down in 2025.Nobody can enroll in these after 3/31 using SEP integrated plans election code

The new DSNP HMO and PPO for full medicaid was introduced so these people can still enroll past 3/31.The OTC will probably be 30-50 more.The big problem is that in Florida 40% of duals are Full Medicaid so defending from the call centers is going to be brutal

 

[hockeyday]

ya Humana pulled that in MI last year, I moved all but one of mine before the call centers got them, DSNP people will move for 30 bucks ..