[mtdjed]

I signed up for Medicare Part D Well Care. Plan has no monthly Premium and has a $0 cost for Tier 1 Meds if I use preferred provider CVS.

I don't understand how the plan works. Does the government subsidize CVS/ Well Care. If I do not pay, what is the incentive for CVS and Well Care?

[retiredguy123]

Yes, the Government subsidizes Medicare Part D.

[Stu from NYC]

I would contact Shine for best answers to your questions.

[vintageogauge]

I changed over to Wellcare in December and what a savings, zero premiums and most of my prescriptions are free. It saves my wife and I just about $250.00/month. I wish I would have known about this earlier.

[Dusty_Star]

Originally Posted by mtdjed

I signed up for Medicare Part D Well Care. Plan has no monthly Premium and has a $0 cost for Tier 1 Meds if I use preferred provider CVS.

I don't understand how the plan works. Does the government subsidize CVS/ Well Care. If I do not pay, what is the incentive for CVS and Well Care?

I also have WellCare. I signed up because of the no premium & because I have no prescriptions. My idea is to watch it & if I need prescriptions in the future, then to get the best lowest care plan for my situation. Which circles around to your second question, the no premium, is probably subsidized by higher costs, higher up the ladder.

[OrangeBlossomBaby]

If you have Part D, that means you're not on an "Advantage" plan and pay for part B instead. But part B has a deductible, and doesn't cover everything, and has co-pays, out of pocket expenses, and is basically an 80/20 plan. If you want to flesh out that Part B with coverage for all that other stuff, you have to get a Medigap plan. Minimum for a woman age 65 in Lake County who doesn't smoke tobacco is $43 for plan G "high-deductible" which doesn't start to cover you until you've fulfilled $2875 in the part B deductible AND paid an additional $257 deductible.

Free meds are great if you have expensive prescription needs. But for tier 1 generics, you can usually get a 90-day supply at Walmart for $10 without any insurance at all.

[biker1]

I'm not sure what you are trying to say but if you are suggesting that you don't pay the Part B premium if you are on an Advantage Plan then you would be wrong. If you select traditional Medicare, then Part B coverage, and its premium, are actually optional (although the majority of people do select Part B coverage).

Originally Posted by OrangeBlossomBaby

If you have Part D, that means you're not on an "Advantage" plan and pay for part B instead. But part B has a deductible, and doesn't cover everything, and has co-pays, out of pocket expenses, and is basically an 80/20 plan. If you want to flesh out that Part B with coverage for all that other stuff, you have to get a Medigap plan. Minimum for a woman age 65 in Lake County who doesn't smoke tobacco is $43 for plan G "high-deductible" which doesn't start to cover you until you've fulfilled $2875 in the part B deductible AND paid an additional $257 deductible.

Free meds are great if you have expensive prescription needs. But for tier 1 generics, you can usually get a 90-day supply at Walmart for $10 without any insurance at all.

[biker1]

I had the Wellcare Plan in 2024 and kept it in 2025. You might want to look into finding a Medicare "broker". They are a great source of information. We talk to our broker once a year and she advises us on whether we should make any Part D changes. She pointed out the Wellcare plan to us for 2024.

Originally Posted by vintageogauge

I changed over to Wellcare in December and what a savings, zero premiums and most of my prescriptions are free. It saves my wife and I just about $250.00/month. I wish I would have known about this earlier.

[retiredguy123]

This thread is about Medicare Part D, which covers prescription drugs. Part B does not cover prescription drugs. So, why are we discussing Part B? The Government subsidizes Part D. That was the question the OP asked. There is no free lunch. Does anyone think that the Government doesn't subsidize Part D?

[mtdjed]

Originally Posted by OrangeBlossomBaby

If you have Part D, that means you're not on an "Advantage" plan and pay for part B instead. But part B has a deductible, and doesn't cover everything, and has co-pays, out of pocket expenses, and is basically an 80/20 plan. If you want to flesh out that Part B with coverage for all that other stuff, you have to get a Medigap plan. Minimum for a woman age 65 in Lake County who doesn't smoke tobacco is $43 for plan G "high-deductible" which doesn't start to cover you until you've fulfilled $2875 in the part B deductible AND paid an additional $257 deductible.

Free meds are great if you have expensive prescription needs. But for tier 1 generics, you can usually get a 90-day supply at Walmart for $10 without any insurance at all.

As the Original Poster, let me clarify. Yes, I am on Original Medicare and a supplement and not an Advantage plan. Reasons and costs of that decision are not an issue.

However, for the most part medications are not included. Thus, I chose a Medicare Part D plan even though my medications were few and inexpensive. Choosing a Part D Plan also comes with a protection from catastrophic costs (currently capped at $2000 per year).

I originally chose a plan Caremark (Aetna) with a (Growing) premium and tier one costs started at $0 but grew to $30/qtr. This year I investigated options and explored Well Care which has no monthly premium and Tier 1 costs are $0.

My question was geared to how does Well Care pay the admin and product costs associated with people like me. Yes I know some drug costs are low, but they are also ensuring that my Max costs will not exceed $2000.

I know that the government provides funding for Medicare Advantage programs but have not seen any descriptions of funding Medicare Part D plans. (Other than assistance for some beneficiaries.)

[retiredguy123]

Medicare Part D is a Government program. If the providers didn't get money from the Government, they wouldn't offer the Part D plans. Also, the $2,000 out-of-pocket maximum is most likely costing the taxpayers a bundle in subsidies.

[OrangeBlossomBaby]

Originally Posted by biker1

I'm not sure what you are trying to say but if you are suggesting that you don't pay the Part B premium if you are on an Advantage Plan then you would be wrong. If you select traditional Medicare, then Part B coverage, and its premium, are actually optional (although the majority of people do select Part B coverage).

Yes you can "not" get part B coverage, or any health coverage at all. But if you go that route, you're probably wealthy enough that you can afford to pay out of pocket, and who cares about part D plans or B plans, in that case. If you change your mind after the cutoff date, you'll pay more than whatever everyone else is paying because of the lifetime penalties.

But if you go the route of A+B+D, then you will be covered for less than if you got Advantage. In order to get the same coverage that Advantage offers, you have to add Medigap. Medigap is not free to anyone. So you'd be paying the $185 for Part B, plus an additional minimum of $48 and as much as an additional $200 if I recall correctly, for Medigap if you're a female non-smoker age 65 in Lake County.

The point is that the "savings" by paying 0 for part D through Wellcare, might be offset by the "extra cost" of the co-pays, deductibles, out-of-pocket costs, and additional premiums for better coverage via a Medigap plan. You save $50 a quarter, but you pay an extra $50/month for the Medigap.

That's what I was implying. In order to get *comprehensive* coverage, you have to either pay extra for Part D and Medigap, OR you have to limit your choice of providers and more restrictions by choosing the less expensive Advantage plans instead (because if you choose Advantage, then it'll cost you at least the $185 that Part B costs currently).

[biker1]

Yeah, I know all that as I am on Medicare, unlike you, IIRC. I was referring to your statement, that I highlighted in your post and included below, that suggested that those on an Advantage Plan did not have to pay the Part B premium. That is not true. I see you have attempted to correct your mistake but in the future, why don't you just say "my bad", instead ?

If you have Part D, that means you're not on an "Advantage" plan and pay for part B instead.

Originally Posted by OrangeBlossomBaby

Yes you can "not" get part B coverage, or any health coverage at all. But if you go that route, you're probably wealthy enough that you can afford to pay out of pocket, and who cares about part D plans or B plans, in that case. If you change your mind after the cutoff date, you'll pay more than whatever everyone else is paying because of the lifetime penalties.

But if you go the route of A+B+D, then you will be covered for less than if you got Advantage. In order to get the same coverage that Advantage offers, you have to add Medigap. Medigap is not free to anyone. So you'd be paying the $185 for Part B, plus an additional minimum of $48 and as much as an additional $200 if I recall correctly, for Medigap if you're a female non-smoker age 65 in Lake County.

The point is that the "savings" by paying 0 for part D through Wellcare, might be offset by the "extra cost" of the co-pays, deductibles, out-of-pocket costs, and additional premiums for better coverage via a Medigap plan. You save $50 a quarter, but you pay an extra $50/month for the Medigap.

That's what I was implying. In order to get *comprehensive* coverage, you have to either pay extra for Part D and Medigap, OR you have to limit your choice of providers and more restrictions by choosing the less expensive Advantage plans instead (because if you choose Advantage, then it'll cost you at least the $185 that Part B costs currently).

[MplsPete]

Originally Posted by mtdjed

I signed up for Medicare Part D Well Care. Plan has no monthly Premium and has a $0 cost for Tier 1 Meds if I use preferred provider CVS.

I don't understand how the plan works. Does the government subsidize CVS/ Well Care. If I do not pay, what is the incentive for CVS and Well Care?

A google search revealed something called a base beneficiary premium for Medicare Part D. It is $36.78 per month, a 6% increase in 2025.
I suspect this is the incentive.

[mtdjed]

Originally Posted by MplsPete

A google search revealed something called a base beneficiary premium for Medicare Part D. It is $36.78 per month, a 6% increase in 2025.
I suspect this is the incentive.

As the OP, my point is not Advantage vs Original Medicare. Simply stated the issue was for those getting Medicare D drug plans.

The cost is for premiums and Meds when required. There is not a set premium for all providers.

I switched from an AETNA plan that had a $52/Mo to a Well Care Plan which has a $0 premium. My Meds are 2 Tier 1 items which cost me $240 per year on the AETNA plan and are now $0 per year.

Total cost is now $0 per year for plan, Drugs and a Yearly limit for out of pocket drugs as required by Med part D government regulations. Those are the facts in my case.

The question was simply How does a Part D provider make a profit on that scenario? The next question was asking whether the USG provides funding to Med Part D Plans.

I have searched the web and find no indication of USG funding Med Part D other than reference to fund some Part D beneficiaries who might have a financial need.