What is Going to Happen to Advantage Plans with ObamaCare?

[summerof18]

I read and hear different things.
Does anyone know any good information on what will happen to the Medicare Advantage plans come October?

Are they going away? or not going to offer the Part B refund?

Is this going to be hell for us agents or amazing? Lol.....

Thank you,
Confused

 

[Yagents]

Besides taking 300 billion out of the program, nothing will happen. Unless you believe that taking that amount of money out of this system will increase the premium, or reduce benefits. Ever push on a balloon before?

 

[bluediamond]

Well according to UHC and Humana they expect Med Advantage to grow over the next few years. I never dealt with return of Part B so I don't have to worry about that part. We do hear thru the grapevine our plan will still be a zero premium for 2014, but who knows about the co-pays.

 

[JimmyUt]

I read and hear different things.
Does anyone know any good information on what will happen to the Medicare Advantage plans come October?

Are they going away? or not going to offer the Part B refund?

Is this going to be hell for us agents or amazing? Lol.....

Thank you,
Confused

The Part B refund is rare. We had it hear with Universal a couple years ago, but thankfully it and they went down the drain. As for changes, I believe I read somewhere where funding for MAPD's was going up by 3.3% for next year, which in my mind should mean things should continue the way they are. Medicare Boosts Rather Than Cuts Payments To Advantage Plans - Kaiser Health News With that being said, insurance companies tend to be fear mongers and will use any news they can to ramp up profits and jam crappy plans down consumers throats.

 

[timsip]

I think the biggest factor for 2014 will be the star rating. I can't tell you all the zillion points a plan is rated on, but I know that there are several that us agents are mainly responsible for. I contract with two plans in 2013 and plan on retaining them for 2014. One already has their fourth star and I don't see any reason why they would lose that. The other is at three and a half and digging deep to get to number four. Everyone else here in Iowa is crap.

I don't suspect there will be dramatic changes for our plans going into 2014, so it really will boil down to network and formulary again. My last enrollee could have gone with the four star with a MOOP of $2900, but went with the 3.5 star with a MOOP of $3900 due to network. I predict these MOOPs will be even closer next year.

 

[Cenla Agent]

I think the biggest factor for 2014 will be the star rating. I can't tell you all the zillion points a plan is rated on, but I know that there are several that us agents are mainly responsible for. I contract with two plans in 2013 and plan on retaining them for 2014. One already has their fourth star and I don't see any reason why they would lose that. The other is at three and a half and digging deep to get to number four. Everyone else here in Iowa is crap.

I don't suspect there will be dramatic changes for our plans going into 2014, so it really will boil down to network and formulary again. My last enrollee could have gone with the four star with a MOOP of $2900, but went with the 3.5 star with a MOOP of $3900 due to network. I predict these MOOPs will be even closer next year.

True. The big emphases appear to be the star rating and wellness.

 

[selfgen]

what is the benefit of a good star rating? I believe I heard that you are allowed to enroll members of another plan outside of the typical enrollment periods. Yes? No? does it get better than that?

 

[bluediamond]

what is the benefit of a good star rating? I believe I heard that you are allowed to enroll members of another plan outside of the typical enrollment periods. Yes? No? does it get better than that?

5 Star can enroll anytime

 

[timsip]

If you have four starts or better, you get to keep the same amount of dollars coming in from Uncle Sam. If you are below four stars, your cut of the mustard drops. I think you can take it from there.

 

[aheff]

Star rating is going to be extremely important in the future for the carriers. MA carriers will get squeezed on payments from CMS. The higher the star rating, the higher the payment/reimbursement. With margins much thinner, a higher star rated carrier will have a huge advantage.