\ UPDATE: If you have pledged, please continue the conversation at forum.imedicare.com
In Part 1 of How to Start a Medicare Part D Plan, we concluded that starting a Part D plan would require a ~$50 million investment, and that the gross profit of a Medicare Part D plan comes to around $438 per member per year.
In this article we’ll show you what it takes to make a collective medicare Part D plan.
Q: First, how many enrollments do you need to make a Part D plan profitable?
A: Depends on the expenses to win an enrollment. With $0 marketing expenses, 100,000 enrollments would put a plan definitively in the black. By pricing the plan premium below the low income benchmark (as we discussed in the last article), your national Medicare Part D plan will receive ~60,000 enrollments automatically from the low-income patients auto-assigned in a plan each year across all 50 states. However, for a Part D plan to truly win the market, it will need closer to 1 million enrollments.
Q: How does the competition get enrollments?
A: Some Part D plans price their premium below profitability in order to beat the competition. Other plans use insurance brokers to drive enrollments. The commission for these enrollments are around $28 per patient per year for a Part D plan, and ~$400 for a Medicare Advantage plan.
Q: How can a start-up plan beat the competition?
A: One of the best ways is by partnering with pharmacies.
A start-up plan can partner with pharmacies in each community to drive down patient costs. By lowering patient costs, the Medicare Plan would surpass any other plan’s profitability, and have a key stakeholder in each community.
Q: Why would pharmacies partner with a Part D Plan?
A: Because pharmacies would have ownership in the Medicare Plan entity.
Hence, the best way for a new Medicare Plan to succeed is if pharmacies themselves own the majority of the new entity.
To make this collective plan a reality, pledge below.
The moment $50 million in pledges is reached, iMedicare will help with the plan setup, to help make pharmacies a real player in the insurance market.