New insulin coverage for 2021

I thought it would be helpful to see which PDP plans are offering that benefit and which aren't.

From my end I see the following PDP plans

WellCare wellness, value script, value plus
Humana premier
Aarp preferred
Silverscript plus

Major ones that say no
BCBS
Aarp Walgreens
Humana basic/walmart. Basic non commissionable for 2021

Looks like most of the mapd plans are offering it.

Anyone got their marketing in point to reach out to endocrinologists and/or have their data segmented to pull out their insulin clients??

I am somewhat disappointed that ONLY 2 MAPDs in San Antonio appear to be participating in the Program!! I sent e-mails to the area Agent Managers of Aetna and Humana to verify this.

The ONLY ones are UHC and the new plan Devoted Health.
 
Oh how the left forgets Christmas eve aca vote ... Cornhusker kickback.

https://www.healthaffairs.org/do/10.1377/hblog20191220.858191/full/

And then scott brown was elected as repudiation of the bill, and house dems were forced to sign senate version with no reconciliation conference, and jammed it through, to read it later

Brown's election was factor in health care law - The Boston Globe

Remember this when the new scotus gets rammed down your throat before any election changes their ability.
 
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The facts of my ACA book, a tale of winners and losers. Easily solved with medicaid expansion and high risk pool:

The aca winners?

I have miilionaires that get $2000 a month in tax credits and pay $50 month premium because they can control income.

I have over 200 clients that made thousands of dollars by owning an ACA plan via the collapse of the market, over pricing, and huge MLR rebates. Example: premium really $2000 ! Month, client pays $50 month after aptc, but receives a MLR rebate check for $4000 for 2018 and now another $2000 from 2019 plans. Yes, they made money owning insurance. Guess they didn't expect a collapse.

I have 50 clients that still are allowed to own their pre obamacare grandfathered plans. They still own a PPO, and they still are 33 to 50% cheaper then obamacare after 10 years later. All continue to keep, until the carrier bails on the book. Like cigna bailed this year.

Losers.....

We had 12 carriers offering ppo plans in AZ in 2014. By 2017, it was down to 1 HMO. We now have 5 HMOs only. Those that needed PPO networks or mayo clinic or children's hospital have suffered via loss of doctors. But that's OK, they found new ones eventually.

Those that can't afford another mortgage. Rates have tripled and quadrupled since ACA passed, and deductibles have doubled,, and i have the proof with old quote files.

Those that are in good health and just over 400% fpl are screwed and go uninsured because dems outlawed STM plans to 3 month terms, and will do again if elected on state or federal level. $1600 for family of 4 or go uninsured. Nothing in the middle.

My book doubled as those with low income or pre existing conditions could now get coverage. Its pretty easy when i hand out $2.5 million of tax payer money, over a 45 day open enrollment period, and i only have a health license. Scary the size of the open checkbook dems gave me.
 
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Further proof ACA is unaffordable for many with no APTC

CMS: Unsubsidized ACA exchange population declined by 45% over 4 years

https://www.cms.gov/CCIIO/Resources...ubsidized-Unsubsidized-Enrollment-BY18-19.pdf

The report, released Friday (PDF) from the Centers for Medicare & Medicaid Services (CMS), argues that people who don't qualify for income-based subsidies to lower the cost of insurance are being priced out of the exchanges.

"While premiums have stabilized, middle class Americans can't afford Obamacare's expensive premiums," said CMS Administrator Seema Verma in a statement Friday.
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But this is the third consecutive year in a row it has been on a decline. Last year, unsubsidized enrollment dropped by more than 300,000 beneficiaries.
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From plan years 2016 to 2019, unsubsidized enrollment declined by 2.8 million people, representing a 45 percent drop nationally.
 
I haven't seen rates yet, but i believe our unsubsidized 2021 rate is due to rise. I guess that is one of the reasons for the change.
 
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