2025-MAPD & PDP what does your Crystal Ball say?

[DonP]

I see this a boon for the call centers because as MA members get their ANOC they will not be aware that all the MA plans will not be better for 2025 and they will be more likely to start calling the medicare help lines and be fed lies to get them to switch.

I think UHC will be even stronger in 2025 mostly at Humana's and Aetna's expense since they already pulled back some benefits in 2024 compared to most other carriers.I hope they keep their HMO plans Open Access

Without $200 an app marketing money and the $250 an app override there’s no way call centers can survive long term with 50-60% persistency . They make little money in yrs 2-4 as there persistency so bad .It’s a crap business model as is but without the above payments its a bk business model .

 

[Midlevel]

Had a lady call me today bc her husband is stuck on the .50 Wellcare PDP and takes Eliquis. Had to pay the 545.00 ded and now 300.00/month. Want to go on the MAPD her parents have that pays so well. Has A and B Medicare with nothing else other then Wellcare PDP. Said we will get together in October. These stand alone drug plans suck compared to MAPD’s. Can’t imagine how they will be next year.

 

[Special Agent]

Without $200 an app marketing money and the $250 an app override there’s no way call centers can survive long term with 50-60% persistency . They make little money in yrs 2-4 as there persistency so bad .It’s a crap business model as is but without the above payments its a bk business model .

Do you know what the typical FMO override is now?

 

[Hilarious Gorilla]

Agree with the idea that since UHC has been conservative in its investment it will be better positioned. The folks that pay attention to their anoc's will look to move to UHC for 2025.

 

[somarco]

Might be a headwind . . .

Justice Department begins antitrust investigation into UnitedHealth

The Justice Department launches antitrust investigation into UnitedHealth Group.

www.beckerspayer.com

 

[kgmom219]

I think we will see the drug pricing differential between MAPD and Part D shrink.

I am expecting a sale of Wellcare MAPD and PDP to be announced in 2nd quarter.

If you are an MAPD person, you need to buckle up. And make sure anyone you don't get in front of knows to schedule a call in January, "just to check in".

 

[straightnochaser]

Without $200 an app marketing money and the $250 an app override there’s no way call centers can survive long term with 50-60% persistency . They make little money in yrs 2-4 as there persistency so bad .It’s a crap business model as is but without the above payments its a bk business model .

Had a meeting with our wellcare rep yesterday, he is under the impression that CMS are already talking about walking back that final rule for 2025... Time will tell

 

[straightnochaser]

I think we will see the drug pricing differential between MAPD and Part D shrink.

I am expecting a sale of Wellcare MAPD and PDP to be announced in 2nd quarter.

If you are an MAPD person, you need to buckle up. And make sure anyone you don't get in front of knows to schedule a call in January, "just to check in".

Who will centene sell wellcare to? They Just bought them!

 

[sshafran]

I see this a boon for the call centers because as MA members get their ANOC they will not be aware that all the MA plans will not be better for 2025 and they will be more likely to start calling the medicare help lines and be fed lies to get them to switch.

I think UHC will be even stronger in 2025 mostly at Humana's and Aetna's expense since they already pulled back some benefits in 2024 compared to most other carriers.I hope they keep their HMO plans Open Access

Some might but let's be real: how many open, read, and comprehend the ANOCs?

I'd estimate 5-8%.

 

[newbie2001]

Without $200 an app marketing money and the $250 an app override there’s no way call centers can survive long term with 50-60% persistency . They make little money in yrs 2-4 as there persistency so bad .It’s a crap business model as is but without the above payments its a bk business model .

Do you really think we'll see the end of marketing money and overrides? I really like my upline support haha, would hate to lose it.