Medicare prescription drug plans a concern for clients as well as agents
Editor's note: Part of a series on what Medicare clients want to know prior to this year's open enrollment period.
Craig Gussin isnât only hearing from clients going into Medicare open enrollment season; heâs also hearing from his fellow Medicare agents as part of his involvement with several industry associations.
Gussin is president and CEO of Auerbach and Gussin in Carlsbad, Calif., in the San Diego metropolitan area.
âThe comment I am hearing from agents is that this will be a tough Medicare season,â he told InsuranceNewsNet.
Medicare Advantage plans and prescription drug costs are top issues for Medicare clients and their advisors, Gussin said.
He said one big issue in his geographic area is that one of the biggest hospitals in San Diego, along with two of the biggest physician networks, announced they no longer will participate in Medicare Advantage plans because of their reimbursement rates. This is leaving clients scrambling to find alternate coverage.
âOne big question in all this is whether other hospitals around here will do the same,â he said. âClients are worried. You have clients who are paying anywhere from zero to $20 a month for their Medicare Advantage premiums and now their doctors wonât accept their plans. So they have to either switch doctors or go to a supplement that costs them more money. And clients donât like either of those options.â
Gussin said agents in his area were notified that two carriers in his area will no longer pay commissions on their Medicare prescription drug plans.
âSo the question for agents is, will we be able to afford to sell Medicare prescription plans because of how much time it takes to find the right plan for someone?â
Gussin said he also is concerned whether Medicare prescription drug plans will increase their premiums to cover the costs of some of the provisions in the Inflation Reduction Act. Â Among the provisions taking effect in 2025 is a $2,000 annual cap on out-of-pocket Medicare prescription drug costs and a $35 out-of-pocket cap on insulin.
âWhen you start looking at this, insurance companies will ask themselves, âHow can we afford this? Well, weâre going to afford this by increasing the premiums,ââ he said. âWill Medicare Advantage plans do this? We donât know yet.â
Gussin said a big part of this yearâs Medicare enrollment period will be educating clients about their options, costs and networks.
âThe biggest takeaway for us will be education. Itâs the education process and trying to fit that square peg into the round hole.â
© Entire contents copyright 2024 by InsuranceNewsNet.com Inc. All rights reserved. No part of this article may be reprinted without the expressed written consent from InsuranceNewsNet.com.
Susan Rupe is managing editor for InsuranceNewsNet. She formerly served as communications director for an insurance agents' association and was an award-winning newspaper reporter and editor. Contact her at [email protected].
Parties seek stay of deadline for fiduciary rule appeal decision
Life insurance sales deliver strong rebound in second quarter, Wink finds
Advisor News
Annuity News
Health/Employee Benefits News
Life Insurance News