Are The Part D Changes Affecting Medicare Advantage Plans Too?

[zl55lz]

With the many comments I have been seeing about the impact of the new regulations on Part D for Rx premiums and such, I was wondering if anyone has noticed changes to the actual Medicare Advantage plans because of this?

For example, an Advantage plan I saw for 2023 with zero premium and $3200 max out of pocket will apparently be $5900 out of pocket with a $22 Rx premium in 2024.

Seems like a large increase. Probably a good thing to review plans each year in my opinion.

 

[badatmath]

I wasn't aware you could change MA plans. Not that I plan to buy one anyway.

 

[zl55lz]

I wasn't aware you could change MA plans. Not that I plan to buy one anyway.

Current regulations allow one to change every open season (yearly) with some other times allowed as well for certain situations.

Advantage plans do not currently require underwriting when changing like Medigap plans sometimes do.

 

[ShokWaveRider]

Looks like WellCare Part D will do well for us in 2024. I checked today and can save $13 a month by going with them. They cover all our drugs at $0 Copay and if the S$#t hits the fan there is GoodRX, Costco or we can upgrade plans to cope.

 

[stedmakr]

Advantage plans are one year contracts. You have two opportunities to change plans every year.

From KFF (Kaiser Family Foundation)
If you are currently enrolled in a Medicare Advantage plan and would like to switch to traditional Medicare, or switch to another Medicare Advantage plan, you may do so during the Medicare Open Enrollment period, which runs from October 15 through December 7 each year, or during the second Open Enrollment Period just for people in Medicare Advantage plans (the Medicare Advantage Open Enrollment period), which runs from January 1 through March 31.

 

[zl55lz]

Here is a link to an article about different events which allow a change in Medicare Advantage plans, even outside of open season.


https://www.aarp.org/health/medicar...s Medicare entirely or shuts down. More items

 

[Sunset]

Current regulations allow one to change every open season (yearly) with some other times allowed as well for certain situations.

Advantage plans do not currently require underwriting when changing like Medigap plans sometimes do.

Interesting and surprising to me, as I would figure that insurance companies would not want to take on a new customer diagnosed with cancer or some other extremely expensive disease.

This seems like it would encourage some Advantage provider to strongly encourage their newly diagnosed customer to jump ship to some other company, by putting up various roadblocks and delay to treatments.

 

[Gotadimple]

Interesting and surprising to me, as I would figure that insurance companies would not want to take on a new customer diagnosed with cancer or some other extremely expensive disease.

Most pre-existing conditions were eliminated recently.

Medicare Advantage plans aren't allowed to underwrite, but changing from Medicare Advantage to a Medigap plan means you would be subject to health underwriting and could be refused.

Medicare Advantage plans have to take anyone who applies regardless of pre-existing conditions. Under MA, the carrier receives the majority of the Part B and Part D premiums and can charge a monthly premium. However they are assuming the risk of paying for all care - even if the cost exceeds what they collect from a member.

As for a physician encouraging a patient to apply for MA vs. Traditional Medicare - it wouldn't matter. MA will not cover any medical procedure that is excluded in Traditional Medicare so any switch to MA is not for providing coverage but a cost consideration. However CMS does expect MA to provide for things like hearing aids.