I began my transition a little sooner. As soon as it was evident that ACA was passing, I started focusing more on Medicare. I still did some ACA stuff, but as carriers began pulling out of the market, I felt it was pointless. Every time I would talk to someone, very few of their doctors were in the network. We had doctors offices telling patients they weren't accepting Marketplace plans. It just wasn't worth dealing with for $10 per month. Then, God forbid you had someone lose group coverage or turn 26 outside of open enrollment. If you enrolled them you didn't get paid.
Opinions on what is expected with the final rule for Medicare
- Thread starter YourMiHealthAgenc
- Start date
I began my transition a little sooner. As soon as it was evident that ACA was passing, I started focusing more on Medicare. I still did some ACA stuff, but as carriers began pulling out of the market, I felt it was pointless. Every time I would talk to someone, very few of their doctors were in the network. We had doctors offices telling patients they weren't accepting Marketplace plans. It just wasn't worth dealing with for $10 per month. Then, God forbid you had someone lose group coverage or turn 26 outside of open enrollment. If you enrolled them you didn't get paid.
Jim Wright
Expert
- 81
Most of the successful agents I work with have a few referral sources where they may not have great persistency but they always have new business. I would think that working ACA leads would get exhausting.
1. Part of the IRA Part D changes includes a “sort of” 6% cap on premium changes.
2. We will be just fine and focused on MAPD and ACA
But please tell me more about how to run a business when you haven’t even read up on the changes that passed 2 years ago.
(I actually don’t care if you can read or not. I DO care when you make idiotic statements about things you clearly know nothing about and confuse newbies)
I know more in my little finger than you . I know exactly what was passed 2 yrs ago . As I knew you’d come in the mapd pool . 32 million on mapd and 14 mil on med sups . Your little loa and aca agents are fixing to learn the ruthlessness of both
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All I know is that it's not based on the plan's actual premium. Meaning if the plan for 2024 has a premium of $10 per month, it doesn't mean they can only increase it $0.60 for 2025. Here's an article that gives some information on it.
[EXTERNAL LINK] - Part D Premiums Increasing Despite Stabilization Program | Avalere
My question though is what is to prevent a carrier from stopping a plan and rolling out a new plan with a much higher premium?
Also, I suspect we may start seeing some plans no longer waive the deductible for tiers 1 & 2. I also expect copays to increase. Maybe I will be wrong on both of those assumptions.
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Not until you eat your veggies.
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They could roll out a new plan, or like mutual, could they just sit it out for year, then re-enter in the following year?
This past year there were a lot of changes to Part D and most of it was off set by Wellcare going the opposite of all the other carriers going super low premiums and tier 6 low copays makes it seem as though the changes did not change as much as it did
Now if Wellcare did not do that this AEP would have felt very different
That can easily change this coming year among other changes that are most certainly coming
No. And I’ve tried. Trying is defined as 3 conference calls with another agent, KFF and reporters to figure out a way to explain it to a normal person.
Best answer: It’s “sort of 6%” but you can’t use the calculator. The 6% rule is based on a government formula that only our government could create, using multiple factors not related to the consumer facing premium.
