What Seniors Need To Know About Changes to Medicare

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PRIORITIZE HEALTH - Carleen Lachman, Independent Insurance Specialist

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Posted on

Sep 18, 2024

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Pennsylvania - Greater Pittsburgh Area

Congress recently made significant changes to Medicare's Part D prescription drug benefit as part of the Inflation Reduction Act. While some changes aim to help seniors afford their medications, others may have unintended consequences.

On the positive side, insulin costs are now capped at $35 per month for Medicare beneficiaries. This has already provided relief for many seniors with diabetes.Starting in 2025, out-of-pocket Part D drug costs will be capped at $2,000 annually. Seniors will also have the option to spread these costs throughout the year through the new Medicare Prescription Payment Plan. These changes can benefit seniors who rely on multiple brand-name medicines or have fixed incomes.

However, awareness of the new payment plan is low. Medicare could do more to inform seniors about this option, which requires opting in. Seniors should consider contacting their Part D insurers during open enrollment if they would benefit from spreading out pharmacy costs.

The law's drug price negotiation provision has led to some unintended effects on drug development. At least 36 research programs and 22 experimental drugs have been discontinued as a result.Part D premiums have also increased. This year, standalone Part D plans were set to cost 21% more on average compared to last year. Many seniors switched to lower-cost options as a result. The number of available plans has decreased by about 25% since 2020.

Some insurers have moved certain medications to tiers requiring higher out-of-pocket costs, restricting access to previously covered drugs. New rules like step therapy requirements have also been implemented, potentially making it harder for patients to access drugs their doctors recommend.

It's important for seniors to understand these changes and their potential impacts on drug access before Medicare's open enrollment period begins in October.  Contact Carleen Lachman, Independent Insurance Specialist at 724-571-4688 to learn more.  

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Prioritize Health - Carleen Lachman, Independent Insurance Specialist

Medicare/Medicaid/Insurance , , Pennsylvania,

Medicare can be confusing.  Do you have questions about Medicare?   I provide personalized consultation and guidance for your Medicare coverage needs.  Contact me today for a FREE one-on-one consultation.As an experienced Medicare broker, I'm here to simplify the complex world of Medicare and help you find the perfect coverage for your unique needs.  With so many plans available, Medicare can be overwhelming.  That's where I come in.  I offer personalized guidance to:- Analyze your healthcare needs and budget- Compare plans for multiple insurance carriers- Explain coverage options in plain language- Find potential cost savings opportunities- Assist with enrollment and paperwork  Best of all, my services come at no cost to you.  I am paid by the insurance companies, not by you.  Why work with me?- Save time and reduce stress by having an expert do the research for you- Gain confidence that you are making informed decisions about your healthcare- Access ongoing support for questions or issues that may arise- Stay up-to-date on Medicare changes that could affect your coverageLet's work together to find the best Medicare plan that gives you peace of mind and comprehensive coverage.  Call me today!