October is a special month for those with Medicare Advantage and Prescription Drug Plans. Brokers are allowed to start discussing 2025 plans with clients beginning October 1, and you can apply for next year’s plans beginning October 15. This year, you’ll want to have enrollment season on your radar.
The Inflation Protection Act changed how Medicare prescription drug plans are covered by insurance companies. It reduces the out-of-pocket maximum Medicare beneficiaries can spend for prescription drugs from $8000 in 2024 to $2000 in 2025, and payments can be made in installments over the year. This is a great benefit for those who need expensive drugs. The downside is insurance companies will look to recoup their revenue losses by increasing premiums and copays on the larger pool of consumers.
By now, if you are on an Advantage Plan or Prescription Drug Plan (PDP), you should have received your Annual Notice of Change, outlining the areas where your current plan will see changes next year. It has been reported that up to 80% of Advantage and PDP clients (instead of the typical 25%) will shop for a new plan this season because of all the changes happening for 2025. Brokers expect to be very busy, so call to schedule your appointment early if you can.
Some Advantage Plans that you may wish to consider include Part B Rebate plans which reduce your Part B premium, in some cases, by over $160 per month. It is a limited benefits plan, but for those who don’t tend to use their benefits, this is a way to save money. If you are one of over 50% who qualifies for a Chronic Needs plan, you may be attracted to a plan offering those targeted benefits.
If you are on a Medicare Supplement and a PDP plan for prescriptions, your Supplement plan’s benefits remain unchanged, but your PDP plan’s premium will probably go up, and there may be formulary changes, which is the list of drugs covered. There could also be changes to drug tier levels and which drug tiers include a deductible. I’m told that many, but not all, plans will continue to have tiers 1 & 2 (generic drugs) exempt from the drug deductible.
In short, be careful when renewing your Advantage and Prescription Drug Plans this year. If you’re taking prescription drugs, it’s important to compare coverage. There are new tools that compare the cost of specific prescriptions across available plans. And we would be happy to help you.
My expectations are that from October until the end of AEP, which is December 7, brokers and insurance companies will be very busy. If you are working with a broker (and remember their services are free to you), it’s important to schedule a time to go over your plan options and your prescription drug information.
November begins open enrollment for individuals, so now is a great opportunity for seniors to get ahead of the game for 2025.
Should you need help, give us a call. Our services are free and as independent brokers, our job is to help you find the plan that works best for you. I am certified with many different insurance carriers, and I am happy to answer your questions and assist any way I can.
Email me at christian@evergreenhealthins.com or call (850) 687-7606.
Author: Sowal Editor
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