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New Part D $2,000 Max OOP
- Thread starter sshafran
- Start date
Agreed.
Carriers are making money on MAPD. Part D? Not so much.
Look for the pricing disparity to increase as we move into 2024 and beyond
- 4,140
Not really. People that buy Medigap realize there are increases. In the last 4 years I've only had one Medigap person call to switch to MAPD.
Medigap clients that are well informed know what and why they're buying it.
Now, I don't mind selling MAPD, but if you do your job correctly, the switch almost never happens.
- 29,593
I'm in the Donut Hole, and I won't hit a $2K OOP. Next year might be a different story.
I have worked with dozens of carriers over the years . . . and everyone of them do some really stupid things from time to time.
But they seem to excel at coming up with ways to fool the public (and agents) into believing this hot new product is not like anything on the market and it will be years before other carriers can duplicate it.
It's no secret that consumers buy on price and agents sell on price. No one reads the "fine print" so they keep churning out more products that look good but are often overpriced garbage.
They have tons of ways to "hide" $$$ and move it around . . . especially when it comes to health insurance. They have a number of ways to delay or deny a claim and most of the time the policyholder will never appeal it.
Has Don hacked Scott's account?
policywunk
Guru
- 542
I believe this 2000 moop will make even more working medicare eligibles with EGHP and retirees with EGHP plans transition to mapd and to a lesser extent med supps/pdp combo.
I saw the best video on 2023 part d . The guy had slides showing a drug at $1200 a month and visually shows month by month.The troop was only $2300 . ONLY 4% of part d people get into catastrophic phase and only 14% get in the donut hole . So the $2000 will help a very small % of people.
You guys are missing the point here.
It’s only going to help a certain percentage of todays Medicare recipients.
All of us have clients who switch meds (Humira, for example) with significant coupons prior to Medicare that all of sudden go “poof” when they enroll. Whether it’s a move to an infusion center, a drug switch or just stop taking it. So those people are going to hit it.
Then we’ve got the issue that whenever the govt steps in and caps consumer costs, actual costs skyrocket. If you are taking Eliquis now but it’s your only med, so you aren’t hitting a $2K OOP, you will hit it in the coverage gap in 2025 because the actual cost will have increased.
Plus deductibles and copay amounts are going to increase, too.
But the game changer will be actual cost increases and the effect in the coverage gap
It’s only going to help a certain percentage of todays Medicare recipients.
All of us have clients who switch meds (Humira, for example) with significant coupons prior to Medicare that all of sudden go “poof” when they enroll. Whether it’s a move to an infusion center, a drug switch or just stop taking it. So those people are going to hit it.
Then we’ve got the issue that whenever the govt steps in and caps consumer costs, actual costs skyrocket. If you are taking Eliquis now but it’s your only med, so you aren’t hitting a $2K OOP, you will hit it in the coverage gap in 2025 because the actual cost will have increased.
Plus deductibles and copay amounts are going to increase, too.
But the game changer will be actual cost increases and the effect in the coverage gap
