This is the start of the 2nd quarter

I’d describe the next couple of years as a rebuilding period. What does that mean? We may not see much improvement in plan benefits or costs, and this may even become the new normal for a while. Higher premiums, higher deductibles, and higher maximum out-of-pocket costs may continue, while some plans could offer less coverage than they did the year before.

My hope is that after 2027, plans will begin to improve again—becoming more comprehensive while also more affordable. I believe with a fair degree of confidence that neither side of the political aisle wants health plan costs to remain as high as they are now.

I was in Washington, D.C. earlier last month, and later in this email I’ll share some feedback from conversations with Senators and members of the House.

How are ancillary plans going to save Medicare???

I am going to fill you in on a little secret I have been keeping since 2018. I have been storing Medicare plans since that date in writing or in SD memory (cannot be changed).I started doing this for one reason: to track what Medicare plans in the Roanoke area are doing year by year.

And here’s what the data shows: from 2018 through about 2023, plans were relatively stable. After that, costs started rising. If you only look at the premium, many plans still look attractive, because that is usually the last thing an insurance company wants to change. But the internal costs of the plans have been increasing—specialist copays, maximum out-of-pocket amounts, hospitalization, and outpatient surgery costs. Now we are even seeing referral requirements return after being gone for about five years.

From 2018 to 2023, many plans had similar MOOP levels, hospital costs were steady, and ER costs stayed fairly stable. Now, each year, the MOOP continues to climb. Hospital stay costs are also rising and could easily double within the next few years.

What can we do?

Hospital Indemnity Plan
This type of plan can help cover the cost of a hospital stay. In the past, hospital costs on many plans might have ranged from about $1,200 to $2,500 maximum. Now those numbers are looking more like $2,000 to $3,000, and that trend appears to be continuing. A hospital plan can often be set up for around $35 per month, and there is no underwriting.

Cancer, Heart Attack, and Stroke Plans
These plans can be purchased separately, but they are often bundled together. Unlike hospital indemnity, these plans are underwritten, which means you can be declined. That is why it is important to apply before you need them. If you receive a qualifying diagnosis, these plans can pay a cash benefit—often anywhere from $1,000 to $5,000 or more depending on the coverage selected. That money can be used however you need: medications, hotel stays, travel, pet sitting, or other unexpected expenses.

If you have questions, just text me.

540-501-6767

At the end of Feb, I took a trip to DC...

At the end of February, I took a trip to Washington, D.C., primarily to get a better sense of what the near future of health insurance may look like. These were my main takeaways:

1. We should not expect lower health insurance rates this year.

2. International conflict and war are taking priority over nearly everything else.

3. The FDA has significantly accelerated the approval process for certain drugs.

One of the main reasons I went to D.C. was to ask whether lower rates might be on the horizon. The expectation was made very clear: we should not expect that this year.

With so much attention focused on events in other parts of the world, broader health reform will likely have to wait. That said, I do think we may get a better sense of what next year could look like around the midterm elections. More on that to come.

Another important takeaway was the speed at which the FDA can now move on certain drug approvals. In some cases, drugs can be fast-tracked in a matter of weeks when the process used to take years. They are increasingly using predictive models, which are now considered highly accurate—even more reliable in some situations than traditional animal trials, which are becoming less useful than they once were.

Ralphie’s Corner
Healthcare Rule:

1. Need a specialist, test, or procedure? Don’t assume it’s automatically approved. Referrals and prior authorizations can take longer than expected, and delays can throw off your care. Start early and ask questions.

2. Don’t wait until the last minute to get a referral or prior authorization.
More plans are requiring extra steps before specialist visits, scans, surgeries, and treatments get approved. And those approvals are not always quick.

MeadorCare Core Values

MeadorCare isn’t just an agency — it’s a movement to fix confusing insurance.