Medicare Season is Right Around the Corner
The leaves are changing, and the days are getting shorter. It’s nearly that time of year, Medicare season. Yes, I know insurance isn’t your or my favorite thing about the fall, but it is important.
2025 will see some of the largest changes to the Medicare program in 15 years. As always read the changes to your coverage carefully. Here’s 7 things you should know.
Out of pocket prescription drug costs will be limited to $2,000 a year. This is great news for those with high-cost medications.
No more Donut-Hole: The dreaded coverage gap will be eliminated in 2025. This should lead to more steady and predictable out-of-pocket drug costs. Woohoo!
Watch out for drug deductibles: More plans will have drug deductibles for next year. Deductibles are bad because they mean you’ll have to pay more for your prescriptions before the insurance pays. This will especially be the case for brand name drugs and will effect both Medicare Advantage and stand alone Part D drug plans. The maximum drug deductible for 2025 is now $590.
Look for premiums to rise and cost sharing to rise. Due to the more generous drug coverage, it is forecast that premiums for drug plans will rise, and some plans may see significant increases. It is also possible that your out-of-pocket cost share may rise for both brand name drugs and medical copays.
Formulary Changes: It is possible that there will be more changes to drug plan formularies for 2025. We recommend verifying that each medication you take will be covered.
Medicare Advantage benefits may decrease. Due to changes to the funding model and needing to offer more generous drug plan benefits, it is forecast that extra benefits like dental and vision may be reduced on Medicare Advantage Plans. We expect to see prices rise, coverage be reduced, or both on many plans.
The Medicare Prescription Payment Program (M3P) will help seniors smooth out their drug costs by spreading the cost of a prescription over a number of installment payments. This is similar to a budget plan from your utility company. We think the program will mostly benefit people with expensive Medications. If you want it, you must sign up for M3P with your insurance company. This new program will not start until January 1st 2025.
Given all the changes, this year more than ever we are recommending our clients review their plan and coverage options. We’d be glad to help you review your options too!
Important Dates To Know
The Medicare Annual Enrollment Period is October 15th to December 7th, 2024. This is your annual chance to sign up for, or change your Medicare coverage.
If you miss the December 7th deadline, you might still be able to change your coverage during the Medicare Open Enrollment period, which is January 1st to March 31st, 2025.