Remember the 1994 Forrest Gump movie when actor Tom Hanks said, “My Mama always said, ‘Life is like a box of chocolates. You never know what you are going to get.’”
Part D of Medicare is like a box of chocolates because you never know what you are going to get from year to year. Your box is filled with surprises because every year, our research team finds providers who overcharge in the cost of drugs, pull drugs from their formularies, drop pharmacies, change deductibles, and redesign their products by playing shell games with their marketing.
For example, in October of 2014, we enrolled a client in the best 2015 plan based on his preferred pharmacy and current prescriptions. The plan was marketed as Cigna-Health Spring Rx Secure –Xtra with no deductible and a $32.40 per month premium.
Then when we reviewed his plan in October of 2015, the plan name changed to Cigna-Health Spring Rx Secure from Xtra to the word Extra. The first dollar coverage with no deductible was changed to a $250 deductible and his premium was raised 58.6% to $51.40 per month.
But, Cigna lowered the cost of his medications so it would take a longer time to reach his $250 deductible before the plan paid a benefit. In his case, lowering the medication cost meant he would never reach his $250 deductible but would pay $228 more in premium from the previous year.
Now the best plan for 2015 was the companies last year’s worse plan. The same company had a second product named Cigna Health Spring Rx Secure. The company took the medications we used for our Clients previous plan and raised the cost of the same medications so the person picking this plan on Medicare’s website would reach a $360 deductible quicker, and then the plan would pay sooner meaning the shopper would save about $216 when comparing both Cigna plans.
The insurance companies know that less than 20% of Medicare beneficiaries actually review their plans each year. Our clients’ plan would have automatically renewed with the huge premium increase with no real benefits, and the company would have made a nice profit. It would have been worthless to him for the following year.
Fortunately both of these Cigna products are not available for 2017 because Cigna was sanctioned by (CMS) Centers for Medicare and Medicaid services in addition to numerous other violations.
By not reviewing your prescription plan every year, you are putting billions of dollars in the pockets of the insurance providers. Let’s all check our box of chocolates every year to keep the insurance providers honest and competitive like it was supposed to be when Congress first approved the program in 2003.
Take Away Regarding Lack of Transparency by Cigna:
Cigna created two different insurance plan offerings for 2015 with almost identical names. One plan was named Cigna-Health Spring Rx Secure –Xtra and the other Cigna Health Spring Rx Secure.
Both plans priced the cost of a client’s generic drugs exactly the same yet one plan Rx Secure Xtra priced the monthly premium at $32.40 with no deductible and first dollar coverage while the Rx Secure plan’s monthly premium was priced at $31.90 with a deductible of $320.
Because of first dollar coverage with no deductible to meet, the Rx Secure –Xtra was the best plan to choose for 2015.
When the same two products came out for 2016, Cigna did a flip flop and changed the last word on the Rx Secure –Xtra to the new word Extra, added a $250 deductible and lowered the cost of the exact same generic drugs from the previous year by 33% to prevent first dollar coverage so the insured was unlikely to reach the deductible for the entire year, and make a nice profit because the premium for this plan was increased by 58.9% to $51.40. Cigna made a nice profit
due to the premium increase with reduced benefits for the unsuspecting member.
The second product kept the name Cigna Rx Secure, and kept the monthly premium about the same from the previous year by only increasing it from $31.90 to 33.40, increased the deductible from the previous year from $320 to $360, but increased the price for the same generics by 33%. Now this plan was best in 2016 because of the increased cost of medications and the higher deductible meant the insured would meet the deductible at six months, and then get some actual benefits the remaining part of the calendar year while in the other plan the opposite would occur.
Bottom line: Cigna made a hefty profit with the huge increase in the premium from the first product Secure Rx-Extra knowing that about 80% of the insured’s would just automatically renew it without a review yet receive little or no benefits.
The insurance companies know that less than 20% of Medicare beneficiaries actually review their plans each year. Our clients’ plan would have automatically renewed with the huge premium increase with no real benefits, and the company would have made a nice profit. It would have been worthless to him for the following year.
Fortunately both of these Cigna products are not available for 2017 because Cigna was sanctioned by (CMS) Centers for Medicare and Medicaid services in addition to numerous other violations.
By not reviewing your prescription plan every year, you are putting billions of dollars in the pockets of the insurance providers. Let’s all check our box of chocolates every year to keep the insurance providers honest and competitive like it was supposed to be when Congress first approved the program in 2003.
