Why Did Medicare Panic Over Part D 2025
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- Опубликовано: 12 сен 2024
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The Inflation Reduction Act is wreaking havoc on every aspect of Medicare 2025.
In this video I discuss the action CMS / Medicare is trying to take, how poorly thought out it is, how it is not legal and I believe will have significant and harmfull unintended consequences.
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Thank you for explaining this in terms that the average American can understand. These are scary times and all we can do is try to keep ourselves educated and have our voices be heard. Again, thank you for keeping us informed.
You are very welcome.
Thank you for your very intelligent and correct assessment.
You're very welcome
Thank you for taking the time to give all of us information early.
You bet!
While your video does a service to inform viewers as what is coming, the real problem is high prescription drug prices and the insurance monopoly on the drug coverage process. I put way more faith in the Harris ticket in going after the price gouging of the insurance and pharmaceutical industry that I have in a replay of another administration funneling wealth into the pockets of the billionaires. The insurance industry hijacked the affordable care act and it is now set do do the same for the inflation reduction act. And the last thing we need to do is demonize those with the intention to keep fighting for the consumer.
Why didn't she go after big pharma over the past three years?
@@MedigapSeminars it's hard to fathom how delusional some people are.
@@MedigapSeminars
The Biden-Harris Inflation Reduction Act (with its lower prescription drug price provisions) was first introduced to Congress on 9/27/21 - that's almost 3 years ago.
@@MedigapSeminars As early as the first year of the Biden/Harris administration, legislation has been introduced to allow Medicare to negotiate prices. HR 3 that included this was introduced in 2021 but never made it out of committee in the Republican controlled House.
@@MedigapSeminars She was busy fixing the Border🤣
As my other comments here have been deleted, and I assume this one will be too, I have to say that it's disappointing that even when it comes to insurance we have to have partisan fighting and now have to be aware that any advice given could well be through a partisan lens.
Susan - I do not believe anyone is deleting your comments. I certainly am not.
@@MedigapSeminars Good, thank you. Will you be doing a video on how the Trump/Vance ticket would fix this problem?
I count 7 comments from you. I think some of the comments are hard to find because they are buried in replies to other comments.
@@susanphelps1938 no, why do you ask?
Thanks Matt, I like your sense of urgency keeping me informed. I'm paying out quite a sum of money for Medicare and a supplement. I hope they adjust this before it goes into effect!
you are welcome
Thank you, Matthew, for alerting us about these upcoming changes to Part D. If I understand correctly, we must wait until we receive the mandatory letter that is suppose to be sent by CMS (or is the letter to be sent by our current provider?) by October 15th before we know what our options are. Kindly confirm. Since we're not being political, I personally believe that Harris/Walz will do more to protect Medicare and seniors than an autocrat who is only serving himself.
Yes, you should get your infomration by October 15, usually by October 01. Personally, I like RFK Jr's approach - if we have a healthier populous we are less controlled by big pharma and med costs.
Misleading, because as CMS explains in their introduction to the Premium Stabilization demonstration project, the very large increase in plan bids was entirely expected, because Medicare is shifting its portion of the payment towards catastrophic coverage from the back end into the front end. (It's complicated - and easier to tell just part of the story and induce panic.) As always, Medicare will be subsidizing those front end bids by paying for 75% of them, which is how the program has always worked. (You mention the "subsidizing" element but minimize it, as if the subsidy is just a trivial amount, and as if it too is a trick and not actually foundational to the entire Part D program design.)
Premiums will likely rise, as they almost always do, but not necessarily by a lot. United Healthcare has already stated that the $15 "handout" from CMS is going to REDUCE some of their Part D plan premiums in 2025 vs. 2024. And that means - their premium before this new CMS program was announced was going to be less than $15 higher than 2024. That's clearly not 300%!
As CMS says, there is a big variation in how plans are reacting to the new structure, and they want to stabilize this mostly by reducing plan risks. Not primarily with that relatively small $15 handout, but mostly by modifying the "risk corridors" to make plans liable for fewer losses, should they be incurred. But don't you think $15 is such a small enticement, that if CMS believes $15 would actually make a real difference, maybe plan premiums weren't about to leap as high as you suggest?
Also, it's not correct that the risk corridors redistribute money from successful plans to unsuccessful ones. It's not a relative thing - every plan could lose money, and it's not that the ones that lost relatively less will pay towards plans that lost relatively more. Each plan individually has to shoulder 5% of losses, share the next 5% of losses 50/50 with Medicare, and then share the rest 20/80 with Medicare - regardless of whether other plans are successful. That is not a taking from the rich to give to the poor. It's shared risk-taking. With the demonstration project, CMS is planning to cover much more of those potential losses. If you think it's communism - well, no private insurer would take on the risks of offering Part D plans without this shared risk-taking, so if anyone is a communist, I guess it's the big insurers?!
CMS thinks that within 3 years, things will settle down as plans will have figured out through some experience how to better deal with the new structure, and how to compete effectively. The whole point of this is that some plans are believed to be overreacting, leaving the market unbalanced, with some affordable plans and some unaffordable ones - which will destroy competition, leaving very few remaining choices. Sure, there are ultimately winners and losers in any endeavor, but CMS doesn't want this IRA transition to put some plans out of business essentially overnight. I mean - give them a chance to figure it out! CMS wants to save the competitive market, to continue to give consumers choices. That's how I see it. Perhaps I'm naive or confused, but let's hope it works.
THIS RIGHT HERE!!!! Thank you JohnYoungT
@@schristinef6352 You're welcome. In fairness, I've played a bunch of Matt's videos today and previously, and I think his advice usually seems sound to me and apolitical.
I think there's a lot of legit concern right now about where Part D is headed. And there is justifiable dismay that some insurers apparently aren't going to be paying commissions on Part D plans in 2025. Some of it is probably underhanded and is putting at risk the livelihoods of agents who perform important services. And, putting at risk seniors - if agents can't help them make the best choices, it stinks for everyone.
The articles out there in the press that accuse CMS of injecting more money into Part D just because it's an election year - I just think that's too cynical. Like so much politics these days. If this market turmoil had happened last year instead, I suspect CMS would have done the exact same intervention.
1, CMS oes not have the authority to alter law just because they do not like the outcome. 2. If this was "known" before hand, why the multiple sudden changes in policy right before the consequences become public? 3. There is much more disruption than what I mention in this video. The Inflation Reduction Act is reducing consumer choices as mutiple insurance companies are abondoning Medicare Advantage and Part D plans entirely. Other insurance companies are cutting the number of plans available to the consumer by 2/3rds. you are suggesting that CMS is trying to save a competitive market by reducing competition. That's like saving Democracy by eliminating voter choice.
@@MedigapSeminars guess we're just too "cynical " by pointing out the OBVIOUS!
@@MedigapSeminars well said, Matthew!!
What would we do without you, Matthew? Thank you!
You are welcome
I really appreciate your no nonsense/ no drama approach to working with Medicare. Please, please, PLEASE leave out the political angle. Using the word "communist" only fans flames. The Inflation Reduction Act covered a lot of ground. And does a lot of good. When problems arise we need to solve them, not blame the human beings who worked on this. This is not scary, just a glitch to be corrected.
Really???? So naive!
Matthew did not use the word "communist" - but I did. The name "Inflation Reduction Act" is just a stealth name meant to obfuscate the truth about this very harmful legislation. This is what communists do to deceive the masses. Reading the book "1984" could help provide insights. Please listen to RFK's speech from yesterday where he exposes what has happened to the Democrat party.
@markfristedt3270 care to list all the "good " the IRA does? When you do, make sure not to include any "good things" that are completely offset by the "bad things " it does (those pesky "unintended consequences "). I'll wait. Hint: it's not reducing inflation.
@@schristinef6352 I'm the troll? Lol!
At 4:17 you state that the plan is to reduce part D premiums by $15 a month, correct? So I’m not quite sure what the panic is about. Any cause for concern is three years away? I only have a few prescriptions and I got my projected increase from Aetna. it looks like the premium will increase one dollar to six dollars a month total.
The plan is not legal. Government bureaucracy do not have the ability to create law or to abridge law.
Aetna is canceling most plans and reducing their formulary because of the IR Act. Also, kicking the can down the road is not the answer to a very serious problem, nor is it legal.
@@MedigapSeminars Thanks. I’ll verify my plan with them. I appreciate all the updates.
So standard procedure, kick the problem down the road for some other sod to try to fix
Yep. I do believe the way to save Medicare is to reduce the consumers dependence on medication. The food we eat is killing us. The doctors we see treat symptoms instead of problems. I believe that RFK Jr approach to the problem is the right way to go
Maybe we should be contacting our Congressmen, everyone who is affected by this shenanigans. Tired of government kicking the can down the road. People's lives and livelihoods are at stake.
Great video thanks!!
😃
Excellent video - thank you Matthew for keeping us informed
Thank you for watching
Some who are used to getting high dental coverage on Advantage plans will see dental only covering basic cleanings next year. Nothing is free. When a law is passed, it must be paid for by someone. No more free dentures.
Thank you!
You are welcome
Thank you, Sir!
You're welcome
Its really The Inflation Increasing Act.
Yes, it is.
@@schristinef6352 name ONE misleading thing. Name ONE.
Still waiting....
@@schristinef6352 You must be brainwashed by the never ending lies and propaganda from Biden/Harris and frankly the Marxist Democrat party
@@floridagirl5250 I doubt you will get a reply. People of their brainwashed ilk never have any evidence to back up their false accusations.
Thanks for the insight.
My pleasure!
Ty once again.
This plus my IRMAA charge will be a killer…jeez.
@@schristinef6352 where I live the State and local taxes require an income where an IRMAA charge is a byproduct. Doesn’t mean your wealthy. Get over yourself.
@@schristinef6352what ignorance? Please explain as I gave a logical explanation calling out your rude comment.,
@@schristinef6352 did you know ENVY is one of the 7 deadliest sins?
@@floridagirl5250 - OK girls, but this going back and forth with insults is super immature. I agree strongly with one of you and disagree completely with the other. But how about we try to keep to the point and stay away from ad hominem attacks?
Thank you sir! I suspect the negative comments are from folks not on Medicare...yet. They will have a rude awakening one day.
I start Medicare this year. I hope it's not broken
@@schristinef6352 yet you can't name one example of anything that was untrue in this video. Gaslighter.
@@floridagirl5250I did my comments were removed!! Gaslight don’t think so!!
Its merely another corporate agent CMS
Thanks for explaining this to us your service is commendable for the average middle-class American
you are welcome
So the pharmaceutical industry wants to price gouge. What do you know? If you’re overseas the same drugs cost hardly anything.
You obviously are clueless where the money comes from to conduct research and get new drugs approved for the market. Drugs cost less overseas because those governments have imposed price controls. However, it costs billions to bring a new medication to market in research, development, testing and approval. That money must come from somewhere. Drugs companies get it from the American consumer while the drug is under patent, because we have a free market system. Imposing European style price fixing on pharmaceuticals will cause research into new Drugs and medical devices to completely halt. So the choice would be to have cheap prices on the Drugs we have currently and NO NEW Drugs in the future or pay for research. You may say that the government will just fund the research, but WE are the government and the tax payers provide the funds, so if we want new treatments we have to pay one way or another. I prefer medicine to advance and not stagnate.
What Europe is doing with cheap drug prices is the same as what they do with their defense budgets, they don't pay their fair share which cause the American taxpayer to bear the burden all the while touting they give great healthcare at a low cost to their citizens. We Americans have been footing the bill for them for decades. They have been able to direct their high taxes mainly to social programs because we cover the cost of their defense.
So happy you are on top of this!
Thank you
Politics aside, from what the resource links, it seems to me that caping the OOP from $8,000 to $2,000 is the significant lever here in raising the "front end" premiums?
So, if a plan participant (like me), never gets to even an initial deductible level (lucky to not have serious health issues, and uses mostly generic drugs bought cheaper through GoodRX , etc.) I am stuck with higher premiums for buying limited plan I legally must have. But other participants that need expensive drugs for their medical condition and have met the deductible and perhaps the current $8,000 cap, will pay less in Annual costs.
Is that correct Matthew?
That is correct
THANK YOU Matthew! I knew this move was coming down the pike.
The GOP's record on Medicare is not a good one. I think it would be foolish to think they would do anything that is advantageous for us who are on it.
It beats giving free medical care to 11 million illegals.
I believe the answer to saving Medicare is to change our healthcare system away from treating symptoms and towards treating the root cause of problems. That approach will lead to a change in diet recommendations and the food we eat. it’s pretty much the same thing that RFK Junior suggests. There is no science behind the modern diet and the modern diet is killing us slowly.
sure when the current administration has set up this current atrocity you as a useful dupe say look at the other guy....you're a pathetic person. FWIW the Repss gave you part D much to the bellyaching howls of the Dems. Now explain that since the Dems have had the Presidency for 12 of the last 16 years it's somehow the Reps fault....now who's the fool fool (rhetrocial).
I never suggested the GOP is good on Medicare. But the Inflation Reduction Act, regardless of intent, is a disaster of unintended consequences. You haven't yet seen what I have on the massive losss of competiion and increased costs for MAPD and Part D in 2025. I am alsove very against beuracracies making law. That is not how this country is intended to function. The voters are a check and balance to bad decisions.
Thanks
Thanks Matthew!
You're welcome! I'm glad you found the video helpful!
So, my injection drug Leqvio (cholesterol lowering LDL) I'm starting it tomorrow, it's not under my Part D Prescription Plan I hope? Because it's not a pharmacy or mail-order supplied drug? It costs a fortune, but approved by Medicare.
Off topic, but my LDL is also a little high. There are some studies that say having LDL that's elevated a little means you'll live longer. Who knows? But you should definitely look up information about the "cholesterol myth".... personally, I would never use that drug, or any other statin. Maybe you can find a functional MD who is not dictated to by Big Pharma. Best to you.
Well, my opinion on this and I am not a doctor is to perhaps research this a little bit further. Below is the link to start your process. Statins, cholesterol, lowering drugs, are known for very serious and life-changing side effects. And truth is that lowering cholesterol may lower your risk of heart disease, but it increases your risk of all cause mortality. in other words, you might not die of heart disease, but you’re much more likely to die of a stroke, cancer etc. This goes to the root problem that we have with healthcare costs. Doctors are taught to prescribe drugs and not taught to solve problems. Many studies show that LDL cholesterol is a non-event. But there are no drugs that can increase your HDL. That comes from lifestyle and food. So big Pharma has tried to change the argument that your health is dependent on LDL cholesterol when that is simply not supported by science. www.nature.com/articles/s41598-018-38461-y
@@MatthewClaassenCMT - This wisdom makes me even happier that I went with your team when starting Medicare on January 1st of this year. My other half will also be starting within the next year. Thank you!
Additionally, I went with a Mutual of Omaha supplement, not only because their price was the best for me in my state, but also because they don't trade on Wall Street. I tend to believe that all insurance (health, auto, home) should be non-profit. The idea of insurance is to pool resources to reduce risk and not to make a profit for the insurer. Please correct me if I'm wrong or missing something about this.
@@blueskyes99 Agree! There is a lot of fear mongering about a high LDL. LDL is a part of the hormone making system. The part of cholesterol that is dangerous is the triglycerides and Drs don't even say a peep if triglycerides is high. Why? Because of the money everyone makes by putting millions of people on cholesterol lowering drugs. There are so many other ways to lower any part of the cholesterol make-up that don't need a drug.
@@blueskyes99 I wouldn't take a statin either, and have refused for 15 years. ( My cholesterol is high, no fooling) This is entirely different, learned of recently. Google it if you haven't heard of it. My cardiologist said if Medicare would pay for it they'd take all patients on statin off and switch to this.
I am already insurance poor. Medical, Auto, & Home Insurance. Something has got to give or I give up
Best medicare content on the internet. thanks.
When will our friends in washington stop paying for goodies with my kids and grandkids money? and in 10 years, when medicare is insolvent, MY money!
Excellent video, sir! I'm also an agent.
Thank you
Is part D a requirement for supplement plans?
With the price of medications, it seems like it would be a grave error not to have some type of coverage😳
I don't believe it's a requirement, but there's some kind of a monthly lifetime penalty fee added if you decide to get it later. (I am new to Medicare as of Jan. 1st. Matthew's office helped me secure both a supplement and a no-premium Part D plan for 2024.)
1% per month penalty for every month you go without Part D. Lifetime.
Part D is for Prescription Drugs that you pick up at the pharmacy or mail order. Without it, you run the risk of bankruptcy in retirement (something I have seen multiple times). Yes, there is a permantnent penalty of 1% of the average annual premium for every month you do not have Part D, paid for the rest of your life.
@@blueskyes99 Part D is for Prescription Drugs that you pick up at the pharmacy or mail order. Without it, you run the risk of bankruptcy in retirement (something I have seen multiple times). Yes, there is a permantnent penalty of 1% of the average annual premium for every month you do not have Part D, paid for the rest of your life.
300%??????!!!!! 🤯
Ya, I know. Even worse, some insurers have exited the Part D market for 2025. Others have closed all but on plan.
@@MedigapSeminars - Wow. I wonder if there will still be a zero premium plan for those of us that rarely use pharmaceuticals?
@@blueskyes99don't count on that (I'm an agent).
@schristinef6352 coming from you, I'll take that as a compliment.
@@schristinef6352 Projection 101
I don't know but if you are on a drug like Humira which always take you to the catastrophic phase and your out of pocket is reduced from $8000 to $2000 a year, even with the 300% increase in premium you still come out winning with the IRA. Of course this applies only to people with expensive drugs like me.
That is true. The maimum out of pocket helps about 1.5 million people out of the 30 million plus on Medicare. What people have not yet seen isn't just the premium. It's the fact that the number of Part D plans will shrink by at least 30%, the extra benefits in Advantage plans and the number of Advantage plans will decline considerably. There will be less competition and higher costs for everyone.
Make sure to thank Kamala Harris for the tie-breaking vote on the Inflation Reduction Act that caused this mess.
Ya 😠
@@MedigapSeminars Now that answer makes me think that maybe you're trying to scare us into voting for Trump/Vance. Am I right?
@@susanphelps1938 Just the truth.
@@russjackson2444 Are you answering for Medigap Seminars?
VOTE!
Off topic but you’re looking good! Looks like you’re getting healthy!
Thank you. I am trying!
thanks matt!! unbelievable!! the socialists strike again!! i will pursue my representative to make a permanent solution to this issue!!! i'm on a fixed income and cannot afford a 300% increase in part D!! looking forward to your future videos on this alarming subject!!!
Look up your new rate in October and remember who told you 300%.
Yes, except as Matthew said, this is a fluid situation. We can hope - though any relief could only be an election year ploy until it strikes again the following year.
@@tomm5897 300% is a statistic provided by CMS
@@blueskyes99 Let's hope
@@MedigapSeminars In the NAMBA, not in actual customer premiums.
We need to reduce the price that pharmaceutical companies can charge not the prophet that insurance companies make why are drugs so much cheaper in Canada buy up to 50 60%
Vote Red
"I dont want to get political, but" [then inserts political comment].
Oh, get bent! This is totally political, As.Hat! You deserve whatever price increase you get, bro!
Kinda hard to dodge it since it's legislation that caused this development and politicos created it😎
@dennislaplant95...this is totally political, dear one. Can't fix st..p..id.
@@schristinef6352 So where’s your video?? You might what to correct your grammar first, however.
@@schristinef6352 Project 25 is a liberal myth /lie put out to harm Trump's campaign.
Stop Stop getting politico! it is not a good look for you.
I don't enjoy it, but this is not about taking political sides. This is having a significant negative impact on Medicare and on people's lives. I will oppose a degrading of Medicare no matter who or shich political party I have to argue against.
@@MedigapSeminars
Then I look forward to your scathing review of the proposed negative impacts on Medicare put forth in Project 2025.
@@dennislaplant95 Project 2025 does not exist. It has been denounced several times by Trump and he fired the people involved with it.
@@MedigapSeminars Why would Trump denounce something that doesn't exist? Why would he fire people involved in something that doesn't exist? How could they even be involved in something that doesn't exist? I don't see your logic. Project 2025 absolutely does exist and Trump is on record praising the Heritage Foundation leader, Kevin Roberts, for "doing an unbelievable job."
@@MedigapSeminars Project 2025 absolutely does exist - whether Trump publicly supports it or not. Many MAGA supporters are using it as a roadmap for a Trump 2nd term.
You underestimate the intelligence of your clients with this clearly misleading video. And I do not appreciate political propaganda being generated by my (former) insurance broker.
Wow - there will be many clients to replace you. But have you done your own research on this that can disprove any of what Matthew said?
My business is highly regulated by the US Government. Any action by any party that harms Medicare will get the same reaction by me. If you listen carefully, this video is anti- Inflation Reductiona Act and anti beauracracy creating laws. That's it. Those who have interpreted this as anything else are projecting their own beliefes.
I have VA which is considered credible coverage for part D. I'm skipping Plan B for as close to 2 years as I can and take the penalty. Im doing it to avoid any premiums from medicare. I'm just making sure I don't go to 2 full years and if you don't go 2 full years you will only be penalized for 1 full year of skipping. Penalty is not much even if prices for medicare yearly do go up. its still rather small. I'm taking full advantage for as long as I can with the VA I have since its free with no copays. Yes I will have a penalty from skipping the plan B temporarily but honestly who cares about the penalty of 40 or 50 bucks in 5 years... The penalty for skipping medicare for 1 full year is only 17.00 a month and yes it increases as prices for medicare increase but we are talking years from now. I also found out that if you continue to skip medicare even in your 2nd year you will only be penalized for one year because it has to be full years. Best to go almost 2 years and then pick it up. I don't even like VA but if I have to use it while skipping medicare for almost 2 years and no premiums then that's what I will have to do... VOTE TRUMP!
Correct, the penaly is 10% of the Part B premium every month for the rest of your life. This video shows the public estimates for the Part B premium for the next ten years. ruclips.net/video/rofCas_taME/видео.html
@@MedigapSeminars Hi, yes I've seen that premium estimate but even if I go to the last date of it 2032 and take that amount x 10% its only 28.00 more a month. Thats nothing imo...Were talking 7 years from now which is quite a lot of time for it to even get to 28.00 more per month. For it to be only that small of an amount and giving me 7 years to get there makes why I much rather skip medicare for a couple years to avoid montly premiums when our country is in bad shape with the dollar ect...I much rather forfeit paying premiums then worry about 28.00 more a month in 2032. Might not be the decision for everyone to do what I'm going to do but for me right now its the best move for me. The fact that I have VA is what is allowing me to do it this way if I want. Some might think its not smart but to not have to pay premiums for medicare for 2 more years with 28.00 more to have to pay because of it is just smarter for me to go that route. I also don't have any health issues nor am I on any medication. Will turn 65 in march 2025 and have until june 2025 to make my mind up about this. Most likely I'm going to postpone though.
Clearly you do want to get political.
@blueskyes99 what you said! Can't fix STUPID with these other folks!
What i want is a Medicare program that works for everyone. I want more competition and fair prices. The inflation reduction Act decreases competition and is increasing prices.
@@MedigapSeminars And how will Trump/Vance fix the system? It would be nice rather than slinging mud at Harris to promote the fixes Trump has in mind. Please do a video on that.
@susanphelps1938 how is it "slinging mud" just pointing out the source of these huge problems? Somehow I think you wouldn't react that way if Trump was blamed...and I'm not an apologist for him, either. Facts are facts and that is what was presented in this video, which contained zero "mud-slinging. " That being said, mud-slinging is certainly called for in this situation, tbh.
@@floridagirl5250 If I recall, in the video Matthew states this was an "unintended consequence." I would also add that the Inflation Reduction Act was a HUGE bill with more than this in it so the pros may well outweigh the cons. And with Harris casting the tie vote, to put the entire blame of this problem on her seems a bit disingenuous. I want to hope that I'm getting unbiased, truthful information but it gets suspect the minute politics get thrown in. I would like to know how Trump/Vance would fix this issue.