Medicare and Advantage Plan providers are touting the “big” change to Medicare in 2025, closing a supposed donut hole as related to the cost of prescription drugs. This and other changes are suppose to save us old folks like me money. All I see for my wife and I is paying more for less coverage.
Medicare cost is going up $11.80 a month to $185 a month. Our Advantage plan through United Healthcare is going up to $48 a month from $36. This 33% increase also includes a lot less coverage. All our dental will cover next year is cleanings, any other dental costs are will be out of pocket. Specialist visits are going up to $55 from $35. My wife has a specialist visit every other month. Hospital stays are going up and we now have to pay the first 4 days instead of 3. They’re touting of prescriptions costs does nothing for us, I don’t pay anything for my regularly prescribed meds, my wife will still have to pay for her eye drops for her dry eye disease, that is about $900 a year. If it wasn’t for GoodRX, the cost of the eye drops would be about $6000 a year. The rest of her meds are at no cost. The quarterly stipend for buying supplies has been cut from $50 to $30. If everything is the same in 2025 as 2024, we will spend about $600 more next year. My 2.5% increase for SS won’t help much with that.
We looked at a couple other advantage plans, they all cost more for the same coverage we now have. If we want to keep the same coverage for 2025 as we had this year, we can each pay an additional $53 a month. We decided to pay less for less coverage and put that $106 a month into a savings account to cover the higher costs of trying to stay healthy. The only bonus we did find is our free gym membership, we can upgrade to the better plan for no additional cost in 2025.
This may not help you much, but maybe it’ll help someone else. I just looked up my meds on Amazon’s new prescription medication program, Mark Cuban’s Cost Plus program, and GoodRx. In every case, Amazon was was less expensive.
I think you either have a very weird set of drugs or are using an insurance plan Amazon has a deal with.
Take the most popular drug in the country, the generic statin atorvastatin. You can get it at Mark Cuban for $5.90 plus shipping. At GoodRx the prices range from $2 to $16.50 ( the lower prices are special offers with GoodRx coupons).
What is the Amazon price for those without insurance? $138.60
I have Amazon Prime. When I click on your link, it shows me $8.30 without insurance, which is less than Cost Plus + shipping. A 90-day supply at Amazon is $10.40. That includes delivery.
Poor people don’t have Prime and it shows $138.60 for them. [As a Prime member you would need to use Private browsing mode and be logged out of your Amazon account to see this price]
If you are in an ‘Advantage’ plan, you’re a sucker.
They are an advantage for the insurance companies, not you. They are the start of trying to convert Medicare back to private insurance companies. Avoid them.
I disagree. Without the advantage plan my wife and I would have to pay for Part D Medicare at $55.50 a month each. Plus we would have to pay a late enrollment penalty because we did not sign up for Part D when we signed up for Medicare. There are also benefits our plan gives us that are not covered under Medicare, our gym membership that we use, slightly better chiropractic coverage and our quarterly stipend to cover the cost of medical supplies. My wife had eye surgery last week, it would have cost $1500 without our advantage plan, we only had to pay $365. I couldn’t afford to not have an advantage plan.
That’s what they want you to think. Wait until you really need something expensive and they’ll refuse to authorize it…for years.
As a nurse I cared for people who literally died waiting for their Advantage plan to authorize something, like chemotherapy infusions for cancer or a breathing machine at home. They literally died waiting while the Advantage plan CEO and stockholders laughed all the to the bank.
Our health insurance provider has been mailing us info about their advantage plans. They all boast about their coverage of Rx, dental, vision and gym memberships. But what I realized is they gloss over the 20% that is not covered. And then the plans lay out how they cover your hospital stays and X-rays and blood transfusions etc etc. they make you pay for the first say five days of a hospital stay, and put limits on what they’ll cover for diagnostic procedures and then the patient pays the rest. Their vision plans steer you to a national chain for services and delta dental offers basic cleanings and minor discounts for dental work.
Personally I’d rather pay for a comprehensive supplemental plan now that will completely cover the gaps that parts A&B do not cover. I’ll pay out of pocket for my dental visits and vision visits. I already do that anyway.
I’ve said this in the other Medicare thread: there’s a reason that insurers like Humana heavily advertise their advantage plans and never advertise their supplemental plans. Guess which plan is more profitable for them?