Does anyone agree with these numbers?

[Duaine]

Medicare Advantage enrollees need less retirement savings for healthcare costs: Study

https://www.beckerspayer.com/payer/...ment-savings-for-healthcare-costs-report.html

 

[Limozine]

I don't. We have MAPD plans in our area with MOOPs as low as $2900. If a beneficiary had the worst possible year from hell every year for twenty years (to age 85) that's still only $58k out of pocket. Reality is that less than 2% of all MAPD beneficiaries hit MOOP in any given year. Even adding in drugs with donut holes, etc. I don't see how they came up with these numbers.

 

[Truce]

I can't access the details of the report, and the summary mentions the wide disparity in drug spend. If the tail risk is in the drug spend, and the drug spend is set to be capped next year, then instead of agreeing whether this report is accurate I'd disagree that it is even relevant.

 

[LostDollar]

I can't access the details of the report, and the summary mentions the wide disparity in drug spend. If the tail risk is in the drug spend, and the drug spend is set to be capped next year, then instead of agreeing whether this report is accurate I'd disagree that it is even relevant.

Reading the summary in the Insurance Forums Staff version of the article,
I question the relevance of the article because it talks about senior spending, but focuses only on Medical Expense.

Perhaps I am an exception, but in my personal experience, I still have to provide for living expense like Transportation, Food, and Lodging as well as some other peripheral items in order to prolong my life and control my medical expenses. The following quote totally ignores that.

The predicted savings target for Medicare beneficiaries to cover premiums, deductibles, and prescription drugs in retirement remains high, and is sensitive to assumptions about premiums, prescription drug expenses, and usage of health care services

from

https://insurance-forums.com/medica...health-expenses-in-retirement-hint-its-a-lot/

 

[somarco]

I think EBRI is operating out of their element and really has no clue where they are or where they are going.

"EBRI has improved on previous iterations of this simulation model by incorporating recent changes to Medicare Part D enacted by the Inflation Reduction Act of 2022 and testing varying assumptions about Medicare Advantage and Medigap plans that Medicare beneficiaries may purchase."


While Medigap plans are standardized it is easier to project OOP health care costs than it would be for MAPD. What assumptions are they using for Medigap premiums? Which plans are factored into the mix?

MAPD have so many moving parts and variations, what did they use here? MOOP can range from less than $2k in some areas to $7k+ in other areas. What assumptions did they make for non-par claims and claims that are denied?

Who commissioned and funded this research?

Here is the full report for those who are interested.
https://www.ebri.org/docs/default-source/ebri-issue-brief/ebri_ib_549_savingstargets-13jan22.pdf

And here are some variables that were not considered, which further tells me the results are useless.

It is also important to note that many individuals are likely to need more than the amounts cited in this report. This
analysis does not factor in the total savings needed to cover long-term-care expenses and other health expenses not
covered by Medicare, nor does it consider the fact that many individuals retire before becoming eligible for Medicare.
However, some workers will need to save less than what is reported if they choose to work past age 65, thereby
postponing enrollment in Medicare Parts B and D if they receive health benefits as active workers.