Prescription Drugs
Catastrophic cap: Under the new drug law, Medicare Part D plan members whose prescription costs are
so high that they enter what's called the catastrophic phase of coverage will not have any more out-of-
pocket costs for the rest of the year once they've spent $8,000 on their medications. In 2025, an annual
$2,000 out-of-pocket cap on Part D spending will take effect.
Extra Help: In 2024 the new drug law is expanding the eligibility for the Extra Help program, which
assists people with limited incomes in affording their prescription drug costs, such as premiums and
copays. The income threshold for Medicare enrollees to qualify for that program will be 150 percent of
the federal poverty level ($21,870 for an individual in 2024), up from 135 percent of poverty.
It's really important for people to see if they could qualify for that program, because it is estimated
there are about 3 million people out there who are eligible and not enrolled. Medicare beneficiaries can
apply for the Extra Help program through the Social Security Administration.
Extra Benefits
Most Medicare Advantage plans offer extra benefits beyond what the law requires. Most often these
include some dental, vision and hearing coverage; sometimes gym memberships, transportation to doctors' offices, accessibility improvements to homes or even meals delivered to homes.
CMS officials say that often Medicare enrollees don't take full advantage of some of these extras and
may not even realize they are entitled to them.
Under a proposed regulation, expected to be finalized in 2024, halfway through the year, insurers will
have to send a letter to enrollees letting them know what services they are entitled to but have yet to
begin using.
Personal Note
I want to thank all of you, my dear clients, for your business and trust. There have
been so many changes with Medicare recently and it has been especially confusing and challenging.
I'm happy I was able to help those of you who needed to make changes this past Open Enrollment.
And I especially appreciate those of you who have referred your family and friends to me so that I
could help them navigate the Medicare maze. My business is built on relationship and trust and I
appreciate your confidence in my services. Thank you for being a valued client!!
Listen to Jim on The Word on Wealth KCBQ AM 1170
at 10:00am every 1st and 3rd Saturday
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