Medicare News

July 2024 Edition

My goal with this newsletter is to:

1
Keep You Informed I will be sharing current articles about the changes in Medicare.
2
Answer Your Questions I'm available to answer issues specific to you.
3
Stay Connected I want to make Medicare coverage as simple as possible.

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2025 Medicare Perfect Storm

Your Prescription Drug Benefits

An elderly couple looking concerned while looking at a cellphone and holding a credit card

If you have either a Medicare Supplement/Medigap plan plus a stand-alone Part D Prescription Drug Plan OR a Medicare Advantage Plan with the Part D Drug Plan built-in, there are some changes coming in 2025 that are going to impact a lot of people.

Annual out-of-pocket costs will be capped at $2,000 for people with Medicare Part D in 2025, which sounds good! BUT….just because Congress votes to have CMS (Centers for Medicare and Medicaid Services) put a cap on out-of-pocket copays for drug plans, that does NOT mean that the drug manufacturers are going to be capped on what they charge for the drugs. And the money for increased drug charges has to come from somewhere … as the old adage goes -there are NO free lunches. If the drug manufacturers are going to charge more for their drugs (which many will), it's going to fall on the insurance companies to foot the bill. And the insurance companies are NOT going to willingly make up the difference between increases in the actual cost of the drug and what they can charge you for that drug.

We are anticipating that this could result in much higher premiums for the stand-alone drug plans that work with Medicare Supplement plans, and probably higher percentage copays for Tier 3 and 4 drugs. There may even be higher copays for the Tier 1 and 2 drugs. It is also expected that the formularies for these plans will become more anemic. If there are 10 drugs that treat a specific condition, the formulary may only include 7 or 8 of those drugs. And there could be even fewer in future years.

With Medicare Advantage Plans, since the insured doesn't pay a premium or deductible for the drug part of the plan, the only way the insurance company can try to minimize the costs of the drugs is to have fewer drugs on the formulary, and possibly increase the copays for the different Tiers of drugs. We can only speculate what will happen, but since many of the drug plans for 2024 doubled, tripled and even quadrupled in premium, it seems likely that that could happen again for 2025.

If you have not already checked out options such as GoodRX or Cost Plus Drug Company, it may be worth your while to do so. You may also want to ask your doctor if there are any generics available that you could switch to if you are using a brand name drug. Anything you can do now to prepare for what may come this fall is a good idea. For those of you with a stand-alone drug plan that works with a Medicare Supplement plan, I will be sending out a form in mid-September for you to fill out with your prescription drug names, dosages and frequency. With this information I can get a head start on trying to find the most appropriate drug plan to meet your health and financial needs for next year.

We are committed to helping you find the most cost-effective coverage available. Whatever happens, we will work through this together.

Personal Note

I am so happy that we are on the other side of May grey and June gloom. We are certainly enjoying our blue sky days as we head into summer. Diana and I enjoyed a lovely week in Hawaii in June and are refreshed and relaxed. We are still dreaming of the stunning blue waters!! We are looking forward to fun times with all of our kids and grandkids over the next couple of months. Blessings to you for the summer and beyond and I look forward to working with you to stay ahead of the curve for this year's Open Enrollment.

Jim and Diana Robeson on their vaction in Hawaii

Jim and Diana Robeson on a boat during their vaction in Hawaii

Jim and Diana Robeson infront of a helicopter during their vaction in Hawaii

Listen to Jim on The Word on Wealth KCBQ AM 1170
at 10:00am every other Saturday

Jim Robeson CLU, ChFC	Medicare Made Easy 10755 Scripps Poway Pkwy #617 San Diego, CA 92131\| (858) 935-9120 jim@themedicareanswerguy.com themedicareanswerguy.com
Disclaimer - We do not offer every plan available in your area. Currently, we represent 10+ organizations and over 100 products in your area. Please contact Medicare.gov or 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

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