NAVIGATE MEDICARE’S 2025 CHANGES WITH CONFIDENCE DURING ANNUAL ENROLLMENT

Significant updates to Medicare Part D make this year’s AnnualEnrollmentPeriod(AEP)crucial—explorenewcaps onout-of-pocketcosts,newthree-phasebenefitsandmore to optimize your coverage.

Now through December 7, Medicare Annual Enrollment Period (AEP) is your opportunity to review and adjust your Medicare plan to ensure it meets your needs for the upcoming year. This year, several significant changes to Medicare Part D make it even more critical to review your coverage.

Changes to Medicare Part D include:

  • Cap on Out-of-Pocket Costs: Starting in 2024, annual out-of-pocket spending for prescription drugs will be capped at $2,000. Once your drug costs exceed this amount, you won’t have to pay more for the rest of the year. However, this may lead to increased premiums or changes in your plan’s coverage, such as approving only generic medications instead of brand-name drugs.
  • Elimination of the Coverage Gap Phase (Donut Hole): The coverage gap phase (also known as the “donut hole”) will be eliminated. Medicare Part D will now have a simplified, three-phase benefit: a deductible phase, an initial coverage phase, and a catastrophic phase. The initial coverage phase will extend until your costs reach the $2,000 annual cap. After this, in the catastrophic phase, you will pay $0 for covered medications (within the plan’s formulary).
  • DrugPriceNegotiations: Medicare will start negotiating prices for 15 specific Part D drugs, aiming to lower costs and improve access to vital medications.
  • New Drug Deductible: Some plans may add a drug deductible as high as $590. Additionally, monthly premium increases will be limited to approximately $2 to help manage healthcare costs while maintaining access to necessary medications.
  • Changes in Medications Formulary andTierLevels: High-tier medications may come with increased costs and higher deductibles. It’s important to check your plan’s formulary to understand any changes to your medication coverage, as out-of-formulary drugs will not count toward your $2,000 out-of-pocket maximum.
  • Reduction in Benefits: Please review 2025 summary of benefit for your plan’s upcoming changes.
  • Plan Discontinuation: Certain plans, such as UHC’s $42 monthly PPO and Alignment 007 PPO, will no longer be available in 2025, and beneficiaries will be automatically dis-enrolled into traditional Medicare. If you are affected, call Jose Juarez at (877) 599-5622 for guidance through this transition.
  • MemorialCare Acceptance: Some plans, including those from Alignment and Clever, may no longer be accepted by MemorialCare starting January 1, 2025. If you want to continue receiving care through MemorialCare, contact Jose Juarez at (877) 599-5622 for help navigating your options.

Check MemorialCare.org/MedicareClasses for upcoming classes or call (877) 599-5622 to enroll.

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