ECON Medicare Advantage plans to see 2025 base pay fall

[Walrus]

I don't think these reporters understand how this works. At 65 you automatically get Medicare. Medicare Advantage is a supplement to Medicare. It doesn't replace Medicare.

Reporters don't understand much of anything. I think journalists are about the most ignorant educated people in the culture.

 

[Dr. G]

actually, for the individual, MA plan DOES replace their regular Medicare. Supplement plans merely cover the deductibles and copays of regular medicare, with patient still covered by regular medicare. Advantage plans fully REPLACE regular medicare coverage. Many patients will purchase what they THINK is a supplement plan (such as AARP), but unknowingly got signed up on an advantage plan (because agents get 10x greater sales commission when selling a MA plan than they would get selling a supplement plan. I had patient every day show up to clinic ASSUMING they had regular medicare plus a supplement plan, only for us to discover they suffered a bait-and-switch and got signed up on the MA plan… resulting in many of us providers refusing the accept that MA ripoff plan. Patients go away really pissed and in disbelief, but the official medicare coverage online portal for providers to confirm coverage now shows they are on MA. Patient is stuck with a limited access crap insurance with very few approved providers, some far away.

Absolutely correct Colonel, we deal with this almost every day in my practice.

 

[ShyGirl]

This whole medicare/medicare advantage thing is so messed up. We have been going around and around in circles trying to figure out what is best for DH who just turned 65. I am already on MA that I got tricked into because I didn't know what I was doing when I turned 65. On top of trying to get the right plan for him we got hit with a 1095 for the marketplace insurance he was on last year so even though we don't owe any regular taxes it looks like we will have to pay back some of the money for the advanced payment tax credit bs. We had no idea about this when we signed up. You really have to research this big time and that is not easy because the insurance sales people are trying to get you on the MA plans because they make so much more from them. They lie and pretend that they are medicare and they have all these great plans. Then you get stuck and can't go back. What a mess. I hate obama!

Medicare Advantage is NOT a supplement to Medicare. It is insurance run by private companies and not the government. They can also change the rules any time they want to but you are stuck with the advantage plan if you have had some medical conditions and the gov decides you are too high a risk.

 

[patriotgal]

THIS is correct. Many many patients assume they are on supplement plan, but are actually on MA plan, often without their knowledge or approval, due to insurance agent getting fat commissions to sign up MA plans. Patients don’t know this until a provider tries to bill for services and gets coverage denied.

This is what happened to senile inlaws. Getting it changed back was a nightmare.

 

[Heliobas Disciple]

An excellent resource regarding Medicare A, B, gap plans D for RX medications, F (not available for new enrollees, G, M, and Advantage plans is MedicareSchool.com videos on you tube.

That channel also addresses the myriad of issues facing folks working past the age of 65, military/teacher/Rail Road pensioners and todays video went over the very low COLA for Social Security recipients in 2025 and the increasing costs with all gap plans.

The channel has excellent videos on the six coverage gaps in Part A and B, as well as the true costs of having a D RX medications plan. Which is vital information if you take expensive medications and if you become very sick and require cancer or immune system medication.

The channel also has videos on the penalties for not enrolling in Part D.

Here's another good channel on youtube re: medicare;

https://www.youtube.com/@AbtInsuranceAgency/videos

 

[BassMan]

THIS is correct. Many many patients assume they are on supplement plan, but are actually on MA plan, often without their knowledge or approval, due to insurance agent getting fat commissions to sign up MA plans. Patients don’t know this until a provider tries to bill for services and gets coverage denied.

Very confusing. Will use mnemonic "Medicare (Dis)advantage" to remember...
...sounds like a play on words, like the "Patriot Act".

 

[CaryC]

I thought that in 2024, if you don't have a Part D plan of some sort, you will pay a penalty. That's why I got a very cheap one.

I might be wrong about that, but that was my understanding at the time.

You can't do anything now but when enrollment comes up in Oct. you may want to check out Wellcare. especially if you don't have any drugs to take.

I don't know if you have to or don't have to have a PDP. but Wellcare is 0.50 a month premium (that's not a typo) and tier 1 is free. Which covers a lot of drugs. And since the premium is 0.50 a month, a 90 day supply of a different tier (tier 2 isn't bad at all) even if it turns out to be 50-60.00 for a 90 day supply without the premium is still cheap.

And they will let you pay for a whole year at one time. 6.00.

Just a suggestion. And all of that may change by next year.

And I'm not sure you'd do any better with Goodrx.

 

[bracketquant]

Reporters don't understand much of anything. I think journalists are about the most ignorant educated people in the culture.

My understanding, directly from a few journalists themselves, is that if you go to college and wash out, but still want get a college degree, you are channeled toward a journalism degree. They say that it is nearly impossible to flunk out of that major.

 

[SlipperySlope]

Wellcare is the cheapest drug coverage here too. Since no one covers the one expensive drug I take anyway I might as well take the cheapest plan. You have to recheck every year though as things change. I do also take 2 generic blood pressure pills and they are free.

 

[Meemur]

Yes, I signed up for Wellcare since I take zero drugs. When you mentioned the $6 premium, that reminded me. I will keep an eye on it and switch during the next enrollment period if it goes up too much. It's my understanding that the Part D can easily be swapped around, unlike other plans.

 

[et2]

We have WellCare drug plan D … zero premium for our plan. Cost share about $70 mth.

 

[CaryC]

Yes, I signed up for Wellcare since I take zero drugs. When you mentioned the $6 premium, that reminded me. I will keep an eye on it and switch during the next enrollment period if it goes up too much. It's my understanding that the Part D can easily be swapped around, unlike other plans.

It can. I am on my 3rd Company since I've been on Medicare/PDP. It's not a problem, just have to wait for the enrollment period. Then inform your doctors after the 1st of Jan on the change especially if you are on maintenance drugs.

Like I said earlier in that one may be stymied on changing Medigap the Part D PDP is something one needs to pay special attention to each year. For those on drugs since it is all the same drugs with a vast variety on price.

 

[BUBBAHOTEPT]

I will soon have to navigate all this BS. It makes my head hurt.

Don’t be dismayed. It really is easier than you think. There are a lot of really good YouTube videos that make it simple with examples. The hard part is analyzing the cost.

View: https://youtu.be/TJCE4pKoKvc?si=yMtZs5WFKyPRP9V3

This guy is pretty good. Watch the basics first from him and others explaining Medicare. Then you will understand his comparisons. Again, it all gets down to how much you want to spend and what is covered.
Here is another person that explains well…..

View: https://youtu.be/xw7EiH-5iik?si=-UMLIeIzK5BC9Zht

 

[nomifyle]

DH had humana drug plan for a couple of years. When I signed him up for it it was cheaper than the copay he had to pay at the VA. The cost that year was something like $17. The second year it went up to $30, didn't seem too bad, but the third year it was doubling to $60. I said ain't no way. Humana gave me grief saying I could not cancel unless I had another plan, well duh, he has the VA. And there was nothing he could do about it. Since covid he has not had to pay a co pay. Such a blessing.

Me, on the other had, since I'm service connected, have to pay nothing. I'm so blessed. When I raised my right hand to swear allegiance to the constitution, which I was proud to do, had not idea how way down the line I would have such a wonderful benefit. I am a Viet Nam "era" vet and at 77 my peer group is dying off. I'm blessed and thank God for it every day, through out the day.

The VA is not perfect, but neither is other health care. I'm also blessed that the VA I go to is a good one, some are not.