Prioritize Health - Carleen Lachman, Independent Insurance Specialist

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.  

What is Medicare?Medicare is a federal health insurance program that gives you access to specific coverage and benefits. Medicare is different from health insurance you may have had before. It offers you a variety of coverage options and it has key enrollment dates and guidelines you need to follow. Were here to help you make sense of it all. How is Medicare Different From Other Health Insurance?You may be surprised at the differences between Medicare and other types of health insurance. If youve had health coverage through your employer, your plan likely included medical and prescription drug coverage, along with other benefits. It also may have covered both you and your spouse.Medicare only covers one person at a time. This means you and your spouse must enroll separately. In addition, Medicare gives you options that can make it possible to receive your benefits in a variety of different ways.You can:       Choose hospital and medical coverage delivered through the federal government.       Add prescription drug coverage delivered through a private company.       Purchase a supplemental insurance policy from a private insurer that can help cover some of the costs.       Choose coverage from a private insurer that combines hospital, medical and often prescription drug coverage into one plan.In short, with Medicare you can choose coverage that fits your needs, budget and lifestyle. We can help you take full advantage of that freedom. Who is Eligible for Medicare?      - Age 65+      - Under age 65 with certain disabilities      - Have End-Stage Renal Disease (ESRD) When and How Do I Apply?If youre like most people, youll enroll in Medicare around the time you turn 65. Your Initial Enrollment Period begins three months before your 65th birthday, includes the month you turn 65 and ends three months after that birthday.Keep in mind that if you dont get Medicare during this Initial Enrollment Period, you may have to pay Medicare Part B or Part D late enrollment penalties. Plus, you could be missing out on coverage and benefits that can help protect your health and finances. Thats why its generally a good idea to enroll as soon you can. How you enroll generally depends on if youre getting benefits from Social Security, the Railroad Retirement Board or the Office of Personnel Management.Contact me today at 724-554-7989 for a FREE consultation.