Have you received your notification that Kaiser will not be offering an Advantage Plan for at least Washingtion State in 2026?

[hal2kilo]

Yep, just looked at my snail mail and Kaiser is no longer offering their Advantage Plan next year. Is anyone actually surprised with the Medicare funding, congress is trying to shove down our throats! So Fn pissed right now.

 

[iRONic]

I was wicked relieved when I got my 2026 Notice of Changes for my MA insurance policy from Humana!!

Some deductibles increased and a bunch of dental stuff was removed.

 

[hal2kilo]

I was wicked relieved when I got my 2026 Notice of Changes for my MA insurance policy from Humana!!

Some deductibles increased and a bunch of dental stuff was removed.

What was weird, I ignored the big bold Notice, and kept looking for the price increase, and their was nothing there, I ran into a list of other advantage plans in the area, and I went back and looked at what the notice said.

 

[iRONic]

That sucks!

My October SSDI DD was on time. No idea if the November DD will be impacted by the shutdown. 😡

 

[Muse]

Just looked at my summary of changes for 2026 from my HMO, Kaiser Permanente (California). Substantial cost increases for various services probably averaging around 30% or more. Monthly premium is going up 41%! Copays appearing for many services free this year. I wonder if Trump & company have axed federal support. They're going after Blue states.

 

[Fenixgoon]

My girlfriend told me her health insurance premiums are going up 75% and the max OOP is going from 2k to 10k 🤯

 

[hal2kilo]

Pay attention, this is when you are supposed to realize the emperor has no clothes to hide what is being done to Medicare. You're going to see some shit real soon.
It called REALITY!
For you people living in another universe, this is why the shutdown must exact maximum pain! Probably end up in some Catholic owned piece of shit plan.

 

[Greenman]

I was wicked relieved when I got my 2026 Notice of Changes for my MA insurance policy from Humana!!

Some deductibles increased and a bunch of dental stuff was removed.

Pretty much the same as my Aetna MA plan. Though my max out of pocket for the year went up to $13,900.

 

[esquared]

Yep, just looked at my snail mail and Kaiser is no longer offering their Advantage Plan next year. Is anyone actually surprised with the Medicare funding, congress is trying to shove down our throats! So Fn pissed right now.

It shows Washington State is carrying it in certain areas.
Are you in a zip code that's not listed?

https://healthy.kaiserpermanente.org/washington/support/medicare-health-plans-2026

 

[iRONic]

Pretty much the same as my Aetna MA plan. Though my max out of pocket for the year went up to $13,900.

That’s what you voted for.

 

[Brainonska511]

max OOP is going from 2k to 10k

She only had a $2k max OOP? That is pretty low considering a HDHP that many might individually have could have that as just the deductible.

 

[sactoking]

Medicare Advantage plans can be tough for insurers to run profitability. They first have to develop the product within CMS guidelines then submit a bid for approval. Most approved bids are at levels that cause insurers to lose money. Then during the year the plan has to hit certain quantitative metrics like hospital readmission rates. They also get qualitative, subjective questionnaires sent to members. Those metrics and questionnaires are worked into a star rating, 1-5. The insurer then gets bonus money based on their star rating. They really need to get at least 3 stars to have a chance at breaking even. Profitability isn't really a possibility until 4 stars. And even then CMS takes so long to process and pay that a plan operating in 2025 likely won't see that 2025 bonus money until halfway through 2027.

I did the Financials for a MA plan for 5 years.

 

[SteveGrabowski]

If you're in Part C and your insurer stops offering coverage in the area does that give you another initial signup window where you can't be denied nor subject to underwriting like if you're on Part G and your insurer leaves the market? Can you switch to Part G then from C? Sorry I refuse to call Part C advantage.

 

[skyking]

I bypass all that drama by going with traditional medicare. I get bombarded 4x a day with calls and mail trying to hook me into advantage plans. Seems pretty fucking profitable to me if they can market that hard.
My brother had a mobile X-ray business and played hell getting them to pay for a valuable service.

 

[biostud]

Nope, we just have to deal with the evil socialist welfare state.

 

[BoomerD]

I'm in Grays Harbor county. We moved here in Dec. 2018. Since then we went from ZERO MA plan options to 1 (Regence) to two, (Regence and some other horrible thing), to 1, (Regence) to one, (Wellcare) Regence left the WA and OR medicare markets. Not sure yet what will happen for 2026.

 

[Greenman]

That’s what you voted for.

It must really hurt your soul to see a conservative that's healthy and happy.

 

[brycejones]

It must really hurt your soul to see a conservative that's healthy and happy.

So you're happy your healthcare plan got worse?

That's pretty weird.

 

[biostud]

So you're happy your healthcare plan got worse?

That's pretty weird.

Yeah, you buy insurance but hope you never need it.

 

[sactoking]

If you're in Part C and your insurer stops offering coverage in the area does that give you another initial signup window where you can't be denied nor subject to underwriting like if you're on Part G and your insurer leaves the market? Can you switch to Part G then from C? Sorry I refuse to call Part C advantage.

C and G aren't the same. A is "free" hospital coverage. B is optional doctor coverage. C is managed care run by a private entity and replaces A and B (and D). D is prescription coverage. Everything else is Medicare Supplement. Supplements have their own special rules.

 

[cytg111]

It must really hurt your soul to see a conservative that's healthy and happy.

You guys still dont get this corrupt sack of flesh.

Yea it digs into his pockets same as everyone else, but he can afford it, and the thought of YOU not being able to afford it - is one of the few things in life that gives him a warm fuzzy feeling inside.

Green is not a real boy. Nothing good will ever come from that general direction. Cut out the rot.

 

[hal2kilo]

It shows Washington State is carrying it in certain areas.
Are you in a zip code that's not listed?

https://healthy.kaiserpermanente.org/washington/support/medicare-health-plans-2026

It's very confusing. They listed themselves as serving Kitsap county where I live in their alternate plan, yet they say I have to go elsewhere or I guess stay will them on regular Medicare and have to get a supplemental drug plan all in the same notice! About to go down there and have it out with them!

 

[iRONic]

It must really hurt your soul to see a conservative that's healthy and happy.

Shitlol

My soul is just fine, you dumbass. JFC…

 

[nakedfrog]

Just looked at my summary of changes for 2026 from my HMO, Kaiser Permanente (California). Substantial cost increases for various services probably averaging around 30% or more. Monthly premium is going up 41%! Copays appearing for many services free this year. I wonder if Trump & company have axed federal support. They're going after Blue states.

They're going after everyone who isn't wealthy. It's wealth redistribution, but siphoning everything to the top.

 

[iRONic]

They also get qualitative, subjective questionnaires sent to members. Those metrics and questionnaires are worked into a star rating, 1-5. The insurer then gets bonus money based on their star rating. They really need to get at least 3 stars to have a chance at breaking even. Profitability isn't really a possibility until 4 stars. And even then CMS takes so long to process and pay that a plan operating in 2025 likely won't see that 2025 bonus money until halfway through 2027.

I did the Financials for a MA plan for 5 years.

My wife is a lead PM of a crew of offshore devs that build that INSANELY powerful & complicated software system for a fortune 500 company.

Hearing the zoom, conference, and video calls that are part of that business/universe is a huge insight under the hood of capitalism and corporate culture.

It’s ugly AF!!