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Newsletter

Medicare - March 2024

IN THIS ISSUE...
  • ALWAYS ASK FOR THE GOOD RX (OR OTHER) DISCOUNT PRICE


  • RISING COSTS HIT MEDICARE ADVANTAGE CARRIERS


  • DEMAND FOR SERVICES EXCEEDS INCREASE IN HEALTHCARE EMPLOYMENT


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News & Updates For Medicare Beneficiaries

Drug prices from discount plans like GoodRx can often be lower than the cost of these drugs purchased through your insurance plan. ALWAYS ask for the Good Rx (or other discount) price when you pick up your medications from the pharmacy and request the pharmacy to charge you the lower of the two prices.


Medicare Advantage insurer profits have been squeezed by the increased utilization of services, and carriers indicate this trend will continue into 2024. Medicare has also proposed a .16% decrease in the benchmark rate paid to Medicare Advantage plan insurers. Both developments could have an adverse effect on Medicare Advantage plan designs for 2025, although it is far too early to know how 2025 Medicare Advantage plans will look.


Although healthcare staffing levels have increased to pre-pandemic trend lines, demand for healthcare services has far outpaced the ability of providers to increase staffing levels to meet the demand.

ALWAYS ASK FOR THE GOOD RX (OR OTHER) DISCOUNT PRICE

It’s a good practice always to ask for the Good Rx (or other discount) price of your medications when you order medications from the pharmacy. 


Most pharmacies do not automatically check the discount price of medications before filling orders for prescription medications from your insurance plan.


I ALWAYS ask the pharmacy to check the Good Rx price before I pay for my medications. Just today I saved $20 (about 25%) over the drug plan price of a new medication my doctor prescribed for me.


RISING COSTS HIT MEDICARE ADVANTAGE INSURERS

Large insurers UnitedHealthcareHumana and Aetna have warned investors and regulators that higher-than-anticipated utilization in Medicare Advantage will cause them to miss their financial targets for 2023 and that profitability may be squeezed this year as well, according to an article in Modern Healthcare.


Health insurers first called out the unexpected spike in Medicare Advantage enrollees scheduling orthopedic, cardiac and other outpatient procedures in June. Carriers and providers attribute the trend to pent-up demand from earlier in the COVID-19 pandemic and anticipate medical expenses will remain above pre-pandemic levels through 2024, although uncertainty abides regarding how long costs will grow, to what degree and for what services.


CMS (Medicare) issued a proposed rule on January 31 to decrease the Medicare Advantage benchmark rate .16% in calendar year 2025, excluding risk adjustment. The agency plans to finalize the rule by April 1. If the benchmark rate is lowered as proposed this, coupled with the increased benefits utilization that has occurred in Medicare Advantage plans, could lead to lower overall Medicare Advantage plan benefits for 2025 plans. However, on February 26 a number of carriers reported improved investment performance in 2023; this should be a factor carriers will consider when designing 2025 plans and negotiating their 2025 plans with Medicare.


Medicare Supplement carriers have begun to announce their premium increases for 2024. One major Medicare Supplement carrier has announced significantly higher increases than their 10 year-average rate increases and attribute this to policyholders obtaining services in 2023 that they postponed due to the pandemic.


We’ve notified clients who have been affected by this increase. We expect larger than expected increases to be announced by other Medicare supplement carriers within the next two months.


We’ll keep you posted.

DEMAND FOR SERVICES EXCEEDS INCREASE IN HEALTHCARE EMPLOYMENT

A February 1 article in Modern Healthcare says the industry has significantly increased staffing over the past few years, returning overall employment levels to pre-pandemic trend lines and leading other sectors in job growth. It’s a monumental accomplishment, but experts say these gains aren’t nearly enough to offset healthcare’s understaffing woes. 


With employee turnover, clinician retirement and health systems building more facilities to meet the service demands of an aging patient population, industry job openings still vastly outnumber the staff available to fill them.


While healthcare employment has increased by around 4.6%, or nearly 800,000 jobs, since February 2020, the demand for services based on spending in the industry has increased by 20%. 

About Paul Cholak


Paul is a licensed, independent health and life insurance agent and has over forty years of benefits experience and specializes in helping Medicare beneficiaries obtain health insurance. However, he offers a complete array of life and health insurance products to individuals of all ages.


He guides Medicare beneficiaries through the steps of getting insurance and is available to help clients both BEFORE and AFTER they've made their purchase decision.


Disclaimer for Part C and D plans: "We do not offer every plan available in your area. Any information we provide is limited to those plans we do offer in your area. Please contact Medicare.gov or 1-800-MEDICARE (TTY: 1-877-2048) to get information on all your options."

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Affordable Care Act open enrollment for 2024 plans began November 1, 2023 and ended January 16, 2024 on the Federal Facilitated Marketplace (https://www.healthcare.gov).

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2024 Annual Enrollment Period For Medicare Eligibles

The Annual Enrollment Period for Medicare-eligibles that ran from October 15 through December 7, 2023 for a January 1, 2024 effective date has ended.

You’re eligible to enroll now ONLY if you’re first becoming eligible for Medicare or are eligible for another type of enrollment period. Enrollment rules differ between Medicare Supplement plans and Medicare Advantage, Medicare Advantage Prescription Drug, and separate Medicare drug coverage (Part D).

Call us at 877-734-3884 (TTY: 711) for details.

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