10/08/2024
The Medicare Annual Enrollment Period (AEP) is almost here! October 15th through December 7th is when you are able to make changes to your plans for the upcoming year, if desired.
There are significant changes coming in 2025 to Medicare Part D Prescription Drug benefits due to the Inflation Reduction Act. Some of the positive changes are –
• There will only be three stages (instead of 4) with the elimination of the coverage gap, otherwise known as the donut hole – the Annual Deductible stage, the Initial Coverage stage, and the Catastrophic Coverage stage. You should know that your insurance company will be responsible for 60 percent, the drug manufacturer 20 percent, and Medicare 20 percent of the cost of your prescriptions in the catastrophic stage.
• The maximum out-of-pocket costs for prescriptions is changing from $8,000 per year in 2024 down to $2,000 per year in 2025. Once you reach your maximum out-of-pocket costs, you will pay $0 for your Part D prescriptions for the remainder of the calendar year.
• The introduction of the Medicare Prescription Payment Plan, which will allow a beneficiary to enroll in a monthly payment plan and receive a bill from their insurance company instead of paying at the pharmacy.
These significant changes could also result in some not so positive changes, for example, increases to prescription deductibles and premiums, changes to plan formularies, as well as a reduction in extra benefits like dental, vision, and hearing on Medicare Advantage Prescription Drug plans. You will want to know for sure how your plan is changing.
While it’s always a good idea to carefully review your Annual Notice of Change (ANOC), it is imperative this year. I would also highly recommend reaching out to your independent health insurance agent who specializes in Medicare to review your options for 2025. The plan you are in now might not be the best one for next year. There is never any cost to work with an independent agent or to get their advice or their help with an enrollment.
If you do not have an independent agent, I would be happy to help you review your options. Please reach out by phone, email, or via the website. Happy Fall!
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