Yep, it’s that time of year again, Medicare Open Enrollment, so it’s time to do your homework and go shopping to make sure you’ve got the best Medicare plan for you.
Open Enrollment Period
Open Enrollment happens every year from October 15-December 7. It’s the time when you get to make changes to your coverage. You can switch from Original Medicare to a Medicare Advantage Plan; change Medicare Advantage Plans; switch from a Medicare Advantage Plan back to Original Medicare; or join, drop or switch Part D prescription drug plans. New coverage begins January 1, 2025.
Starting in 2025, there are some new additions to Medicare.
- All Medicare plans will include a $2,000 cap on what you pay out-of-pocket for prescription drugs covered by your plan. So, it’s more important than ever to make sure your drugs are covered. The cap had been $7,400.
- Supplemental Part D benefits count towards individual out-of-pocket costs
- People enrolled in a Part D drug plan that offers enhanced supplemental benefits will have the supplemental benefits count towards their out-of-pocket costs, meaning they will reach the $2,000 cap sooner. For example, hair growth drugs, even though excluded from Part D drug definitions, will now count toward the cap.
- Also starting next year, you can choose to participate in a program that spreads your out-of-pocket drug costs across the calendar year, instead of paying all at once at the pharmacy. It’s called the Medicare Prescription Payment Plan — and you can opt in with your plan throughout the 2025 plan year. Part D enrollees who select this payment option will pay $0 to the pharmacy for covered Part D drugs, and Part D plan sponsors will then bill program participants monthly for any cost sharing they incur while in the program.
Medicare plans can change from one year to the next, and so can your health needs. For example, I have clients who have received letters from their doctors, telling them they will not accept certain insurances next year. If that happens to you, then you need to find a plan that is accepted by your doctor in 2025.
Also, as the price of drugs and health coverage becomes more expensive, Medicare Advantage plans may change the benefits they offer or change the amount they pay. I have client who have received letters from their plan saying that the over-the-counter benefit will be reduced from $115 per quarter to $65 per quarter. If that happens to you and the OTC benefit is important to you, you’ll need to find another plan.
You can shop Medicare Advantage plans on your own. Ehealthinsurance.com/Medicare is a good tool. I also suggest you contact a local Medicare Insurance vendor in your area, one who is licensed to sell multiple lines of Medicare Advantage plans and Medicare supplement plans. They may be able to provide more information than you can’t find on your own.
Happy shopping!
Disclaimer
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