Silver script $63 a month in 2024 with $525 deductible. Best silver script $116 a month

This MAPD vs Med Supp argument is BORING. Who cares? No one is going to change anyone's mind on this one.

Is it regional? YES. Cost differential between TX and Florida or Connecticut is astronomical. On the other hand, CT has guaranteed issue.

Is the Provider issue regional? To some extent. Not as much as it is in Under 65 (individual or group). Georgia is still very conservative, so gov't control is an issue. TX is the same. The difference between TX and GA is that Top Tier providers in TX do not take HMO's. They are starting to take the MAPD PPO's, but its still not widespread.

Duals in TX have to make less than $1100 a month with less than $7K in assets. They are fine with the limited network and reality is that they can't afford to drive to a top tier provider, anyway. That's brutal, but accurate.

Those who make to much to be on Medicaid but don't have a lot of savings? Those are the ones that I really to see on Plan N. By definition, they can't save money. A $1500 hip replacement is going to be a problem, a $125 premium for N and D is not. And if it increases too much, they can move back to MAPD. But that's a TX answer. It doesn't work in every state.

Anyway...move on...
 
So now the client is better off paying for a Med Sup and taking a chance on their drugs even if they start taking Eliquis in February and have to pay $6600.00 for it the rest of the year and have no dental, vision, gym, OTC vs taking a 0.00 premium MAPD with a terrific drug plan built in and a 3900 max OOP. Oh and they now have dental, vision, gym, OTC, etc. But by God they may be able to get that MRI without PA.

Unbelievable how some people think on this forum.

thanks for your insight! I like your attitude. it’s ridiculous the way some people refuse to admit that MAPDs work!
there’s only 25 million people enrolled in them ya know. I’m sure those 25 million people are just miserable and not getting the care they need. .
 
This MAPD vs Med Supp argument is BORING. Who cares? No one is going to change anyone's mind on this one.

Is it regional? YES. Cost differential between TX and Florida or Connecticut is astronomical. On the other hand, CT has guaranteed issue.

Is the Provider issue regional? To some extent. Not as much as it is in Under 65 (individual or group). Georgia is still very conservative, so gov't control is an issue. TX is the same. The difference between TX and GA is that Top Tier providers in TX do not take HMO's. They are starting to take the MAPD PPO's, but its still not widespread.

Duals in TX have to make less than $1100 a month with less than $7K in assets. They are fine with the limited network and reality is that they can't afford to drive to a top tier provider, anyway. That's brutal, but accurate.

Those who make to much to be on Medicaid but don't have a lot of savings? Those are the ones that I really to see on Plan N. By definition, they can't save money. A $1500 hip replacement is going to be a problem, a $125 premium for N and D is not. And if it increases too much, they can move back to MAPD. But that's a TX answer. It doesn't work in every state.

Anyway...move on...


I have a client moving to Leander , TX sometime later this year. Is MAPD not a good idea? Or if so, go PPO instead of HMO?
What’s the MAPD market penetration in TX?
 
I have a client moving to Leander , TX sometime later this year. Is MAPD not a good idea? Or if so, go PPO instead of HMO?
What’s the MAPD market penetration in TX?

Looks like a little over 45% penetration in the two counties associated with Leander, TX (Travis and Williamson County).
 

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