2025 AEP Disruptions: Updates to The Inflation Reduction Act

[aheff]

Not going to happen.

Especially if you do it properly.

Sell them "estimates" and you're in for a ride... Answering questions about stuff you shouldn't have said.

Stick to the summary of benefits and you're golden.

Post-AEP: "Yes, John, your Eliquis was Tier 3 - just like we discussed: 25% coinsurance. After $545 deductible. They wanted $670 @ CVS? Sounds about right."

During AEP: "No, no no... I do not know what they're going to charge you for it. It'll be 25%. If Eliquis is $100 (it's not), you'll pay $25. If it's $1,000 - you'll pay $250. After the deductible, of course."

"What was that? No... I don't have a better option. Did you want to enroll? Or would you prefer your current plan which will have you pay 40%?"

Not saying I get no calls, because I do, but not a lot. I rigidly stick to what I can rely on - the SoB. And when they try to bring up other stuff (remember Cigna showing everything low estimates on MCGov last year?) - I simply point to facts.

For those of you who don't have a nice size book or are still in hyper-growth mode- its business as usual.
But, for those of us who have a big book.- if you think its going to be business as usual, keep your head in the sand, ignorance is bliss. It doesn't matter how much work you do during AEP or how much you prepare your clients. Like never before, you will be dealing with all you Part D clients during the first quarter of 2025. Most confused, some angry, some really pissed off. Have a blast explaining the smoothing rule or explain again why their premium jumped from .50 cents to $25. And all of this fun maybe without getting a commission.
For Me- Part D plans were alway a necessary evil. Relatively speaking, the commissions weren't worth the time, but it was all part of the service. Now, if I am not getting paid, I will absoutely rethink that service, and probably retreat or significantly modifiying what I do. Sorry, the time, compliance, risk, pissed off clients- no thanks. (caveat, I AM an agent, but I am at the tail-end of my career, so I have the luxury of saying that).

 

[BALDELMO]

More like explaining why their premium jumped from $.50 to $50.00+

 

[sshafran]

For those of you who don't have a nice size book or are still in hyper-growth mode- its business as usual.
But, for those of us who have a big book.- if you think its going to be business as usual, keep your head in the sand, ignorance is bliss. It doesn't matter how much work you do during AEP or how much you prepare your clients. Like never before, you will be dealing with all you Part D clients during the first quarter of 2025. Most confused, some angry, some really pissed off. Have a blast explaining the smoothing rule or explain again why their premium jumped from .50 cents to $25. And all of this fun maybe without getting a commission.
For Me- Part D plans were alway a necessary evil. Relatively speaking, the commissions weren't worth the time, but it was all part of the service. Now, if I am not getting paid, I will absoutely rethink that service, and probably retreat or significantly modifiying what I do. Sorry, the time, compliance, risk, pissed off clients- no thanks. (caveat, I AM an agent, but I am at the tail-end of my career, so I have the luxury of saying that).

You quoted me - I doubt my PDP book is massive but it is over 750 active PDPs. Certainly not a small book of PDPs.

 

[vic120]

is this official now PDP's will not be paid?

 

[aheff]

is this official now PDP's will not be paid?

No idea whatsoever. I think many of us are playing around with different scenarios during this somewhat slower time period.

 

[DonP]

For those of you who don't have a nice size book or are still in hyper-growth mode- its business as usual.
But, for those of us who have a big book.- if you think its going to be business as usual, keep your head in the sand, ignorance is bliss. It doesn't matter how much work you do during AEP or how much you prepare your clients. Like never before, you will be dealing with all you Part D clients during the first quarter of 2025. Most confused, some angry, some really pissed off. Have a blast explaining the smoothing rule or explain again why their premium jumped from .50 cents to $25. And all of this fun maybe without getting a commission.
For Me- Part D plans were alway a necessary evil. Relatively speaking, the commissions weren't worth the time, but it was all part of the service. Now, if I am not getting paid, I will absoutely rethink that service, and probably retreat or significantly modifiying what I do. Sorry, the time, compliance, risk, pissed off clients- no thanks. (caveat, I AM an agent, but I am at the tail-end of my career, so I have the luxury of saying that).

What you’re saying is exactly what I’ve been saying for 2 months . Some called me negative and it will be business as usual . Bs . It’s mass unprecedented in the medicare space raw chaos coming . What agents aren’t comprehending when you explain these changes and possibly move their plans these are regular older non insurance people. What you tell them about copays or coins or whatever will be forgotten in the lag between aep and Jan 1st. These clients for the most part have been paying zero copays at their regular drs and many have paid zero copays for many drugs . Come Jan that first time they fill their generic blood pressure drug that was zero copay and now its $20 will be burning your phone lines up . Plus will many plans have premiums in 2025? The days of the last 5 plus yrs sitting on your book and collecting nice stress free renewals is over with . The days of only having to move 5% of your book aep are over with . There will be massive jumping around this aep and oep .

 

[GoPokes]

is this official now PDP's will not be paid?

The carrier who is last to cut commissions, will likely be rewarded handsomely. My bet is UHC, maybe wellcare. I would think UHC can afford it, they are well diversified and dominant in the space.

What you’re saying is exactly what I’ve been saying for 2 months . Some called me negative and it will be business as usual . Bs . It’s mass unprecedented in the medicare space raw chaos coming . What agents aren’t comprehending when you explain these changes and possibly move their plans these are regular older non insurance people. What you tell them about copays or coins or whatever will be forgotten in the lag between aep and Jan 1st. These clients for the most part have been paying zero copays at their regular drs and many have paid zero copays for many drugs . Come Jan that first time they fill their generic blood pressure drug that was zero copay and now it’s $20 will be burning your phone lines up . Plus will many plans have premiums in 2025? The days of the last 5 plus yrs sitting on your book and collecting nice stress free renewals is over with . The days of only having to move 5% of your book aep are over with . There will be massive jumping around this aep and oep .

How long until the pharmaceutical companies are held accountable for some of these issues? People like to blame insurance companies, but they are caught in the middle. Right now though, they just blame a different middle man, agents/fmo’s.

You’re right people are gonna be upset, when they go use the plans, and it’s more expensive. My father, who takes no meds, was shocked that his PDP could go from $10 to $50+ per month.

It sounds like what we are seeing is the Medicare problem is starting erupt. All these talks about Medicare getting cut in the future, running out of money… well now the coverage is getting worse, it will certainly cause some noise in the marketplace.

I suspect more jumping in Jan-Mar, rather than Oct-Dec.

 

[DonP]

The carrier who is last to cut commissions, will likely be rewarded handsomely. My bet is UHC, maybe wellcare. I would think UHC can afford it, they are well diversified and dominant in the space.





How long until the pharmaceutical companies are held accountable for some of these issues? People like to blame insurance companies, but they are caught in the middle. Right now though, they just blame a different middle man, agents/fmo’s.

You’re right people are gonna be upset, when they go use the plans, and it’s more expensive. My father, who takes no meds, was shocked that his PDP could go from $10 to $50+ per month.

It sounds like what we are seeing is the Medicare problem is starting erupt. All these talks about Medicare getting cut in the future, running out of money… well now the coverage is getting worse, it will certainly cause some noise in the marketplace.

I suspect more jumping in Jan-Mar, rather than Oct-Dec.

I agree most of the movement will be in Jan-March . Medicare agents will now feel what P&C agents have been feeling for 2 yrs. Answering call after call on sky rocketing premiums and people shopping .

 

[kgmom219]

is this official now PDP's will not be paid?

Not at all, its going to be both carrier and state specific

 

[somarco]

Not at all, its going to be both carrier and state specific

Choose your poison.

I looked at the no-comp landscape leading up to 2014 and decided to go in a different direction because I thought it would be more secure.

It appears I may have misjudged . . .

I already have a hobby. Don't need another one.