I was looking at the annual Medicare book they mail to everyone in September ahead of the October season of outrageous Medicare Advantage claims by D-List celebrities which runs October 15 to December 7.
The only Part D plan available from Aetna/CVS, my current insurer, is $35.90/month – over a 1,000% increase from the $3.30/month I’m currently paying. There are a few plans with a $0/month premium. I’ll probable get one of those since my plan is to continue to pay cash for the 3 cheap generic drugs I take rather then get price gouged by the insurer.
I switched from some other company, to the Part D provider I have used the last couple years, because the premium was non-zero. Received the plan update booklet a couple days ago. Deductible went up a few bux, but premium remained at $0.00
That’s how I retired before 40, I refuse to be screwed by the financial services industry.
I posted this little piece of inside information on Medigap plans over on Reddit a few moments ago in answer to a question about Medigap premium increases. Not a chance a Medigap salesman is going to clue you in on this.
{{ I signed up for Medicare in Feb 2021 and called the State insurance commissioner’s office to get the data on consumer complaints for the various Medigap insurers. The analyst told me that Medigap generates very few complaints because there’s not much that a Medigap insurance company can do for you complain about. All the benefit administration and accounting is done by Medicare (CMS) itself, the insurer just pays what CMS tells it to pay. About the only time the State insurance commissioner’s office gets a complaint, is when someone cancels a Medigap policy and the insurer is slow to stop the monthly debit from your checking account.
As a result, the analyst told me you can safely choose the lowest premium offered, they’re all the same.
*United American currently has the cheapest Medigap Plan G high deductible at $48/month where I live in Washington State. Garden State Life Insurance charges the highest ($77/month) for the same policy. *
On price increases, Washington State allows you to switch from one Medigap insurer to another as long as you have a current policy in force, which I will do, if United American is no longer the low cost option.*
Washington is a Community Rating state, so everyone from age 65 to age 100+ pays the same monthly premium. In Attained Age states where your premiums rises with age each year, I’d expect the age 65 premium to be 25% to 30% less.
When I checked the Medical Loss Ratios for Medigap insurers, they were all in the range of 77% to 81%, so they get to keep about 20% of your premium for basically doing nothing – CMS is doing all the work. It looks like a wonderful business. }}
Everyone would be wealthy in this country if we could just prevent the business community from screwing us.
To pick a nit, that is ‘only’ a 900% increase. For example, a doubling on price would be a 100% increase, so a 10-fold increase would be a 900% increase.
It seems like almost all the Part D plans now have a $590 annual deductible.
If I pay cash for the 3 drugs I take, and don’t use the insurance, it’s about $400/yr. With PBM price gouging, using the insurance would have increased that $400 to about $1,200/yr.
That’s the price of having a $30 MM/yr health insurance CEO between you and your doctor.
Penny wise and Pound foolish. Insurance is more about what may happen, than what is happening now. You may only have cheap generic drugs now, but getting hit by cancer could change that in a big way. Hope you will still be covered.
I received notice from United Healthcare for my medicare advantage hmo of changes. Went through drug changes yesterday.
Big change is no donut hole. No monthly premium. Generics still no co-pay. Jardiance is level 3. Used to be $47/mo copay until donut hole and $157/mo after. But they charged list of $600/mo toward donut hole and abt $1000 per yr for generics. So donut hole at 6 mo.
Elimination of donut hole reduces Jardiance from $1k per yr to abt $500. Still hoping for better when we get negotiated prices next year.
You need to have an understanding of arithmetic and insurance (a high bar, I know).
You get the full benefit of the $2,000 cap on Medicare Part D drug costs even with a $0/month premium. (Of course, even with a $0 premium, they’re still getting me with the IRMAA penalty for a high income, but that’s the penalty for success.)
The Part D health insurers are betting that you’re too dumb or lazy to check your generic prescription costs on Good Rx, and that you’ll pay triple the price (or more) to them. That’s a sound bet in America.
About 90% of the prescriptions written for seniors are for generics. Less than 10% of Medicare beneficiaries will bump up against the $2,000 out of pocket limit (even after getting price gouged by the insurer.)
If my kidney specialist suddenly tells me I need a $100,000/year drug, it’s only going to cost me $2,000/yr. (Plus the $400 I paid for the year’s supply of the 3 generics I take – that $400 won’t count towards the $2,000 limit since I paid cash.)
In summary, negotiating prices on 10 or 15 name brand drugs isn’t going to do squat for controlling drug costs. Drug company stock prices have only moved up. The $2,000 annual out-of-pocket limit will be funded by price gouging on generic prescription drugs – paid for by the most ignorant and innumerate Medicare beneficiaries.
I disagree. If a competing drug is on the negotiated list and gets a lower price, you expect other company to lose market share as consumers and their physicians choose the lower cost treatment (perhaps encouraged by their insurance company). Its tempting for the competitor to cut its price to match the negotiated price to maintain its market share.
Negotiated prices do have potential to shift the market and cause others to match adjustments. Hence, the prices may have larger impact than only the negotiated drugs. We shall see.
Let’s not forget how competitive the drug industry is.
I’m reminded of the story of a supplier who cut prices at a major account to get the business. Previous supplier went to Canada and signed all clients to rock bottom priced contracts to punish the offender.
This meant competitor’s salesmen had nothing to sell and could not earn any bonuses for the life of the contract. How do you keep your best people in that situation?
When the health insurer’s PBMs are negotiating the wholesale prices for their own account you see a competitive market. When the health insurer prices the drug at the pharmacy counter for a policyholder, there’s no transparency and unlimited price gouging comes into play.
Don’t forget that the drug negotiation legislation was written by a drug lobbyist (Steve Ricchette) and a health care Private Equity operator (Jeff Zients.) They’re returning to the industry after their Gov’t service.
The drug industry is well known for its “detail” men and women who call on physicians and teach them to prescribe their newest and most profitable drugs. They monitor who writes prescriptions for their drugs and reward them with training meetings often at luxury vacation spots.
This is all part of the industry “marketing” program.
Yep what does that have to do with contributing to society as the best and brightest?
I have seen waitresses that were cute in ice cream shops recruited.
As far as teaching the doctors that is one sad doctor who needs a pharma rep to teach them anything. Worse than sad is the doctor who trusts the pharma rep to teach them much.
Paul, seriously it is dangerous to use new drugs in the marketplace. Horribly dangerous.
Better discipline doctors avoid new drugs like the plaque. That does not mean all doctors are worthwhile.