straightnochaser
Guru
- 817
UHC 2025 First Looks....
- Thread starter Russ
- Start date
WiscBroker
Super Genius
- 120
Checked out the first look today (Wisconsin), most UHC plans OOP jumping, RX deductibles coming back big time, vision benefit going back to every two years, premiums going up slightly, copays TBD up, and they are rolling out a new HMO plan with Rx called Flex Care which will have a $300 quarterly medical expense card in exchange for $6900 pop and higher copays.
Fortunately they have the best network and solid reputation but if they’re changing this much I wonder how bad the others will be.
Fortunately they have the best network and solid reputation but if they’re changing this much I wonder how bad the others will be.
The others will be much worse i assure you. Actually United’s plan areas were stable and rx deductibles in my area were $295 to $430. Humana is a disaster in my areas pulling many plans in certain counties. I assure you Aetna will be cutting massive . United has a big chance to gain a monstrous amount of new members
- Thread starter
- #44
Humana also said there will be a big service are reduction
this is going to be the big thing this year
how many plans will be eliminated
will everyone be scrambling
or worse will they be replaced with similar non commission plans like well care did in NY 10 years ago
Did BCBS training and the plans got much better for 2025. Had a deductible on prescriptions last few years and did away with that.
Also came out with a plan with a reasonable premium with very few copays and $2000 dental, $100 OTC, good vision and hearing benefits and a max oop of $2500.
Then I listened to an Aetna manager try to explain the new IRA rules and she kept saying it's going to affect the Med Sup's and PDP's way more because they don't have anywhere to cut costs elsewhere. Think she just kept saying that about Med Sups bc they are pushing MA plans. She also sounded like the Aetna MA plans are definitely going to have some big changes.
One thing she said that I hadn't read was after the deductible is met if someone goes in and gets a $600 drug and they have an enhanced PDP that has a $47.00 copay instead of the 25% standard copay that the higher of the $47 or 25% is what goes towards the max oop. So even though they only paid $47.00 it meets $150.00 towards their max of $2500.00.
She also kept talking about how bad the payment plans are gonna be to implement since they have no billing system in place bc the MA plans are all $0.00 premium. She also said if a client takes out an Aetna MA 1/1/25 and gets expensive drugs the first couple months and sets it up on payments and then switches to UH effective 3/1/25 that Aetna is still on the hook to try and collect the $2500 and we all know what is gonna happen with that.
Also came out with a plan with a reasonable premium with very few copays and $2000 dental, $100 OTC, good vision and hearing benefits and a max oop of $2500.
Then I listened to an Aetna manager try to explain the new IRA rules and she kept saying it's going to affect the Med Sup's and PDP's way more because they don't have anywhere to cut costs elsewhere. Think she just kept saying that about Med Sups bc they are pushing MA plans. She also sounded like the Aetna MA plans are definitely going to have some big changes.
One thing she said that I hadn't read was after the deductible is met if someone goes in and gets a $600 drug and they have an enhanced PDP that has a $47.00 copay instead of the 25% standard copay that the higher of the $47 or 25% is what goes towards the max oop. So even though they only paid $47.00 it meets $150.00 towards their max of $2500.00.
She also kept talking about how bad the payment plans are gonna be to implement since they have no billing system in place bc the MA plans are all $0.00 premium. She also said if a client takes out an Aetna MA 1/1/25 and gets expensive drugs the first couple months and sets it up on payments and then switches to UH effective 3/1/25 that Aetna is still on the hook to try and collect the $2500 and we all know what is gonna happen with that.
- 2,111
Midlevel said:
Did BCBS training and the plans got much better for 2025 .
Which Blue Cross? My state has three of them, and the regional one (IBX) looks pretty good, except for T3 + having coinsurance not copays.
Did BCBS training and the plans got much better for 2025 .
Which Blue Cross? My state has three of them, and the regional one (IBX) looks pretty good, except for T3 + having coinsurance not copays.
You know the plans being eliminated in each county . Go order your supplies for 2025. Put in all your county’s . Eligible county’s pop up under each county . Some places withdrawals substantial. This is before we even see the crappy plans coming . . United will take massive members from Humana and Aetna . Devoted has great opportunity ti grow from 250 k members to 700 k or so . They have no shareholders to answer to . Almost all there plans will have food cards still . I hear giveback still big . The problem in newer areas is network
Had a client call me last week. Devoted just dropped her two doctors. They could be good but their network is becoming a humana hmo.
I’ll stick to my Florida blue and uhc. Consistency is key with benefits. I don’t try to chase the extra food and crap
So you're not doing free Uber rides this year?
