SMS marketing Zoom Overcoming Medicare Disruption Brought on by the Inflation Reduction Act.

Millwood

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Anyone attend? Thoughts........
Highlights that got my attention.
1. Premiums may be as much as a plan G. Premiums may go up 200%-300%
2. Carriers are responsible for $2,000 smoothing if it's not paid. Can't cancel a members Part D for non-payment of $2000 smoothing payments , but can turn over to collection agencies.
3. Part D carrier responsible for drug costs over the $2,000 threshold.
4. Pharmacy networks will be thinned.
5 . Negotiations on pharmaceutical Prices will not happen until 2026 and 2027. Only 10 drugs will be negotiated for 2026. 2027???


Will it be impossible to find coverage for people on multiple name brand drugs? Will half their drugs be on formularies when there are so many?
Will drug plans pay little or nothing on generics to pay for higher tiers?
How many only taking generics will stay enrolled in a Part D @ $100 mo.
Who was the *** that named this the "Inflation Reduction Act" ?
 
IF . . . PDP premiums increase significantly expect a number of "healthy" folks to drop plans in 2025 resulting in adverse selection. Mostly sick on expensive meds will have a plan.

If that happens the PDP market will implode.

Keep in mind that the taxpayer (federal govt) currently pays 20 - 40% of the cost of drugs in the catastrophic phase.

Yes, there will be fewer plans offered, smaller networks and fewer high priced drugs on the formulary.

Unless PDP will be "underwritten" next year, folks with high priced drugs will still be able to get coverage . . . the question is, can they afford it.

Generic copays on drug plans are mostly outrageous already. Most of my clients use discount cards for generics rather than their PDP.

The Inflation Reduction Act was name by the same bozo's who came up with the Affordable Care Act.

Any questions?

@Ron Van D . . . you were posting while I was composing my post. Great minds and all that . . .
 
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DEVOTED has been bragging for months June end meetings and first looks . Today the regionals send emails “ No plan benefits will be discussed at any of these meetings over the coming months . Things are changing as carriers refile stuff” . Nobody’s giving any info out until aug end or early sept . Means enrollment books might not come until mid Oct. tough times coming .
 
DEVOTED has been bragging for months June end meetings and first looks . Today the regionals send emails “ No plan benefits will be discussed at any of these meetings over the coming months . Things are changing as carriers refile stuff” . Nobody’s giving any info out until aug end or early sept . Means enrollment books might not come until mid Oct. tough times coming .

I wonder if they will discuss network shrinkage like they announced in north florida fora key hospital group
 
Coming IRA prompted changes will impact the D in MAPD . . . those plans are not immune.

Anticipate deductibles, higher copays, smaller formularies and networks.

Things discussed and speculated today may not look the same in August before ANOC's are mailed.

Some MAPD agents may have to learn how D actually works and figure out how to help folks save money.

It seems to me that enrollment books would probably come out at the same time, but that is not my concern

Elections have consequences . . .
 
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I don't know where to have this discussion so here we go...
in the new "compensation" rules it states:
CMS is increasing the final national agent/broker fixed compensation amount for INITIAL ENROLLMENTS INTO AN MAPD OR PART D plan by $100.

question: has anyone seen what we are getting paid on for regular business? The above statement is for T65 etc for "initial enrollment"
Did I miss something?
 
[snip]

Keep in mind that the taxpayer (federal govt) pays 20 - 40% of the cost of drugs in the catastrophic phase.
I believe Medicare pays 20% in the catastrophic phase. Don't think it will be more than that.

All your points are well taken. This fall will be what in the military they call a cluster foxtrot. Except they don't say foxtrot.
 

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