Posted on 10/20/2025 8:48:19 AM PDT by Sequoyah101
This time it is breath taking. Our Plan G premium went up 37%.
Here we go again. Spin the roulette wheel of health care costs and see how high they go. Wonder if it is you being singled out or another gift to the state board of insurance or just what it is and how much.
“Why does this all have to be so darn complicated? Need an accountant to figure it all out!”
Ask Congress.
You want to hear complicated?
Just listen to the rules - set in the law by Congress - for Medicare Part D (prescription drug benefit) if you fail to sign up for it at the same time you start Medicare. If you start late you can be penalized UNLESS all the time between start of Medicare and adding Pat D coverage you were in another “qualifying” prescription drug plan.
ON what theory was Congress operating on when it came up with that rule? When you were not immediately joined in Medicare Part D you were NOT imposing costs - for prescription drugs - on Medicare. You were imposing NO additional costs on Medicare, and in fact were taking care of your drug costs elsewhere, even if just out-of=pocket and not in another “qualifying” plan. So why the penalty> It makes no sense.
And how much is that penalty?
[The penalty for late enrollment in Medicare Part D is an extra 1% of the Part D premium for each full month you were eligible but didn’t have other creditable prescription drug coverage. This penalty is added to your monthly premium and you will pay it for as long as you have Medicare Part D drug coverage.]
So, if at age 65 you felt you did not need the Medicare Part D prescription drug plan, but decided to add Medicare Part D:
one year later, you’d have a premium 12% higher - forever
two years later, you’d have a premium 24% higher - forever
three years later, you’d have a premium 36% higher - forever
ect
ect
Does that make any sense??? NO!!!
For the first seven years after age 65, my health was fairly good and I needed little health care, and I never enrolled in Medicare Part D. As a veteran I was eligible and enrolled with the Veteran’s Health Benefit program, and for a while had a prescription drug issued by them. Thank God!!! I also had other drugs I had begun to get issued privately and paid for them out of pocket.
So in my seventh year of Medicare I found out about adding the Medicare Part D coverage. Had it not been for the VA acknowledging my enrollment with them, my Medicare Plan D premium would have been 89% above standard (89 months late) and it would have remained that way forever.
I cost medicare ZERO in those first seven years, but I was to be “penalized” for finally adding their Part D premiums to my monthly costs. Makes no sense.
“That’s not the subject. The subject is Part D plans are disappearing. They lost critical money in the Inflation Reduction Act.”
You have stated the problem incorrectly.
It is not “Part D Plans are disappearing”.
It is some MEDICARE ADVANTAGE PLANS ARE DROPPING “their” Medicare Part D.
As I said, when that happens, anyone can go back to Medicare Part D coverage provided directly with Medicare.
The way you wrote it it sounds like “Part D coverage” is “disappearing” but that is ONLY in the context of some Medicare Advantage plans, NOT that “locally” Medicare Part D is no longer available!!!!!
EVEN AT THE VETERANS HOSPITALS
“That’s not the subject. The subject is Part D plans are disappearing. They lost critical money in the Inflation Reduction Act.”
You have stated the problem incorrectly.
It is not “Part D Plans are disappearing”.
It is some MEDICARE ADVANTAGE PLANS ARE DROPPING “their” Medicare Part D, or some private insurer sponsored Medicare Part D plans - not the same as straightforward Medicare Part D.
As I said, when that happens, anyone can go back to Medicare Part D coverage provided directly with Medicare.
The way you wrote it it sounds like “Part D coverage” is “disappearing” but that is ONLY in the context of some Medicare Advantage plans, or some private insurers Medicare Part D plans, NOT that “locally” Medicare Part D is no longer available!!!!! Medicare Part D is always available outside of Medicare Advantage plans or private insurer’s Medicare Part D plans.
Are the Part D plans associated with Medicare Advantage plans the ones that are experiencing disappearance or reduction in number?
AI: No, the Part D plans disappearing are not exclusively associated with Medicare Advantage. The decline in the stand-alone Medicare Part D prescription drug plan (PDP) market is a separate trend from Medicare Advantage plan changes. The number of PDPs available to the average beneficiary has decreased significantly, from 30 in 2021 to 14 in 2025, and the number of premium-free “benchmark” plans for low-income beneficiaries has dropped from 8 to 2 over the same period.
This erosion of the PDP market is a major concern, particularly for beneficiaries in traditional Medicare and rural areas who rely on these stand-alone plans for drug coverage.
Last sentence is the focus.
I know what you’re talking about in that penalty for being late. I joined Part D when I was 66 instead of 65, so I was a year late and have been paying a 12% penalty ever since.
As you said, I cost them nothing during that year so why am I paying a penalty? They should be giving me a bonus! LOL never happen!
Giving government any control over it at all was what allowed that in the first place.
The more they try to “make it accessible” or “lower costs”... it gets less accessible and more expensive.
Enough is enough.
As I said, my comments also included Medicare Part D plans offered by themselves by private insurers, not just in Medicare Advantage plans. Those are the “PDPs” the “disappearing” comments apply to - Part D plans provided by private insurers.
And as I said, when that private insurer ends offering a Part D plan, part D coverage is still available directly from Medicare.
Are Part D benefits ever offered directly from Medicare.
AI:
No, Medicare does not offer Part D drug coverage directly. Instead, it contracts with private insurance companies to administer the program.
There are two main sources of Part D coverage: Prescription Drug Plans (PDPs), which are stand-alone plans that offer prescription drug coverage only, and Medicare Advantage plans with prescription drug coverage (MA-PDs), which bundle hospital, medical, and drug coverage into a single plan.
Individuals cannot receive Part D coverage directly from Medicare; they must enroll in a plan offered by a private insurer.
You probably need to rethink this.
I am a solid NO on Advantage except maybe in certain cases. It is not transportable across state lines, that would be out of coverage and subject you to serious cost. We live right on the state line. 20 or so miles to suitable facilities out of state and 100 miles to what I consider less suitable facilities in state. So, no for me. It is also no good if you travel which we don’t much but do sometimes. Transport to in network if I am seriously ill is not acceptable.
Once in the plan always in the plan without being subject to underwriting. You can switch to Advantage any time but you may not be able to go back to G. You can also not switch carriers in G without being subject to underwriting. That is except I am told now in Oklahoma either side of your birthday and that has yet to be tested.
UHC G is the only group rated plan available in Oklahoma. All others are higher at the time i enrolled.
In our hospitalization last Spring the case worker said, “I see you have traditional Medicare and Plan G. You should see hardly any bills at all.” I asked about Advantage, she rolled her eyes and said, “Disaster for many people.” There are always exceptions that are so far not worth the risk.
CDPHP just cut their prescription drug plan in their advantage program and offered something else. I suspect this is a national thing as you suggest.
I suspect you are correct but I had not yet thought in those terms. It is true that Advantage is faltering.
It is Plan G Supplemental Coverage.
I can’t imagine what you have for $44 a month since our plan G started out at about $115 a month each five years ago.
Yes. You are right. I was misled, when I started Medicare Part D under Aetna; I was told it was either Part D with a private insurer or Part D by Medicare direct.
However, what is open, to everyone, twice a year, is just like Medicare, Medicare Part D coverage can be changed from one provider to another.
You’re correct. There are multiple PDPs typically and they need not be associated with a specific Medigap plan chosen.
But this is changing. The laws changed and PDPs are getting scarce. The answer, if you have a desperate drug need, is one of two options — 1) cancel Medigap and replace with Advantage+Indemnity or 2) Relocate to an area where there are PDPs.
Everyone, study but do not stop and decide you know your stuff until you have spoken with a Medicare Insurance agent. Right about now your local senior center is doing Health Fairs. There will be many agents attending. Talk to several. Evaluate their preparation.
Why cancel “medigap” ( a Medicare Supplemental Plan).
They are neither here nor there with respect to Part D??
If one PDP for Part D is “disappearing” there is no greater opportunity Part D is being offered in a Medicare Advantage Plan than another insurer’s Part D plan.
And an “indemnity”plan, as I understand it, has no cash benefit for prescription drugs, only for out of pocket expenses related to hospital stays.
Why cancel “medigap” ( a Medicare Supplemental Plan).
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When you make the choice of Medigap/Part D vs Advantage, you are somewhat tied together. If you lose your Part D option in your area, by whatever cause, (meaning ALL the Part D options in that area are lost) then where can you get drugs?
Answer — Advantage. So you are somewhat asking if you can have both Medigap (with no Part D plan) and Advantage — for its drug program. Interesting.
I won’t paste the entire AI answer. Embedded in it — “It is illegal to sell a Medigap plan to someone who has Medicare Part C (which is Advantage). If you have Advantage, you do not have original Medicare and therefore there is nothing for a Medigap plan to supplement.
And vice versa. If you have a Medigap plan (with original Medicare) it is illegal to buy a Medicare Advantage plan, which is Medicare Part C and would therefore cancel your Original Medicare and also cancel any supplementing Medigap plan. Again, nothing to supplement.
That’s an interesting question. But it’s a No.
There are people out there who are 100% sure that Medicare Advantage is horrible and generates disaster. But as of now, in 2025, with people turning 65 and calling everyone they can for advice, 50% of them are choosing Advantage.
It’s not that bad.
In Re:
“When you make the choice of Medigap/Part D vs Advantage, you are somewhat tied together. If you lose your Part D option in your area, by whatever cause, (meaning ALL the Part D options in that area are lost) then where can you get drugs?.....”
Answer — Advantage. So you are somewhat asking if you can have both Medigap (with no Part D plan) and Advantage — for its drug program.”
Medigap plans do not have Part D.
You can have Part D with a Part D plan from the same insurer as your Medigap plan, or with a different insurer. So a Medigap plan is never tied to any Part D plan.
I cannot imagine someone losing their Part D “option” “in their area”, with “ALL the Part D options in that area are lost” and that loss not including Part D in a Medicare Advantage plan; meaning NO PLACE to go, but out of pocket.
I have a Blue Cross Plan G High Deductible here in Pulaski County Arkansas.
and that is what I am paying and it might go to $48 next year. That is what It said when I looked at open enrollment last Wednesday on the 15th.
They’re trying to push you into Medicare Advantage aka Single Payer/HitleryCare.
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