UHC 2025 First Looks....

[Special Agent]

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?

correction on this the existing UHC Patriot Regional PPO in Florida will degrade to lower rebate of 25.00 and their will be a new better UHC local Patriot PPO with 100.00 rebate.I have about 15 of these so even more work for AEP

And the UHC walgreens will be migrated to the Preferred rx

 

[DonP]

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

Ok i see. So all dsnp’s stay on present plans . So starting aep all fdbe,qmb plus and slmb’s full Medicaid) can move to the new full Medicaid plans with higher benefits . They’ll be able to use the new sep through all of 2025 to move . So regular duals cannot move past oep end 3-31 .. So agents at a huge disadvantage as unless you call all your full duals and run there Medicaid level you don’t know if they’re fdbe or qmb plus . Only about 10% of my book is fdbe as i rarely run into that. My state has no qmb plus and almost no slmb plus . Yes defending will be tough for you . As i said this will be the toughest by a factor of 5 aep every . I have 15% of my Humana plans in different counties non renewing

 

[Special Agent]

Ok i see. So all dsnp’s stay on present plans . So starting aep all fdbe,qmb plus and slmb’s full Medicaid) can move to the new full Medicaid plans with higher benefits . They’ll be able to use the new sep through all of 2025 to move . So regular duals cannot move past oep end 3-31 .. So agents at a huge disadvantage as unless you call all your full duals and run there Medicaid level you don’t know if they’re fdbe or qmb plus . Only about 10% of my book is fdbe as i rarely run into that. My state has no qmb plus and almost no slmb plus . Yes defending will be tough for you . As i said this will be the toughest by a factor of 5 aep every . I have 15% of my Humana plans in different counties non renewing

That rough we just heard that Aetna is not renewing the contract as of 8/1/24 with the only hospital in one of the northeast florida outer metro counties as a way to reduce membership in the less populated less profitable counties.also Florida Blue is terming all their DSNP in north fl ,wellcare and cigna dropping all ppos as well

 

[Chazm]

That rough we just heard that Aetna is not renewing the contract as of 8/1/24 with the only hospital in one of the northeast florida outer metro counties as a way to reduce membership in the less populated less profitable counties.also Florida Blue is terming all their DSNP in north fl ,wellcare and cigna dropping all ppos as well

I’ve seen Wellcares PPO in N FL. I have no idea who would have been on it. No doctors and crap benefits. People need to sell on stability and doctor network. Not to save $5 on a specialist.

I will say that it’s crazy in the panhandle. Maybe 5 companies participate there in 2024. Nuts.

 

[DonP]

That rough we just heard that Aetna is not renewing the contract as of 8/1/24 with the only hospital in one of the northeast florida outer metro counties as a way to reduce membership in the less populated less profitable counties.also Florida Blue is terming all their DSNP in north fl ,wellcare and cigna dropping all ppos as well

DonP was heckled and laughed at for being so negative about chaos coming . The Donpster might be a bit cocky and not liked by some . But he ain’t wrong much

 

[MedicareWAA]

DonP was heckled and laughed at for being so negative about chaos coming . The Donpster might be a bit cocky and not liked by some . But he ain’t wrong much

You’re describing yourself in third person now?

 

[Fisher]

So agents at a huge disadvantage as unless you call all your full duals and run there Medicaid level you don’t know if they’re fdbe or qmb plus .

I'll be sure and block out plenty of time to call those 3 clients.

 

[DonP]

I'll be sure and block out plenty of time to call those 3 clients.

But the huge upside I don’t have to check drs or rx’s on any of these peeps . 90% will stay put

 

[goillini52]

DonP was heckled and laughed at for being so negative about chaos coming . The Dongster might be a bit cocky and not liked by some . But he ain’t wrong much

Hahaha

 

[vic120]

DonP was heckled and laughed at for being so negative about chaos coming . The Donpster might be a bit cocky and not liked by some . But he ain’t wrong much

The Donpster

Wow you coined the phrase