The annual enrollment period for those currently covered by Medicare begins October 15th and runs through December 7th, with selected plan benefits going into effect January 1, 2025. During the enrollment period, you can switch from an original Medicare plan (Parts A, B, & D) to a Medicare Advantage plan, from a Medicare Advantage plan to an original Medicare plan, from one Medicare Part D plan to another, or from one Medicare Advantage plan to another.
As medical costs continue to skyrocket, picking the right plan can save you a lot of money in the long run. Planning for Medicare can be complicated, but we are here to help simplify the process. Original Medicare offers Parts A, B, & D, each covering different healthcare needs. Medicare Advantage plans (Part C) are an alternative to original Medicare. You can also purchase Medicare Supplement Insurance (Medigap) plans which help pay for expenses not covered by Medicare.
It is important to understand that there are four Medicare plan options:
Part A (Hospital) – Provides in-patient hospital, skilled nursing facility, nursing home, hospice, and limited home health care.
Part B (Medical) – Provides preventive services, outpatient care, some home health care, and durable medical equipment.
Part C (Medicare Advantage) – Sold by private insurance companies and takes the place of Parts A, B, & D. Many plans require approval for coverage and are restricted to in-network doctors and hospitals.
Part D (Prescription Drugs) – Helps cover the cost of prescription drugs.
Over the last few years, there have been many changes to address Medicare beneficiary costs, with more coming down the pipeline in 2025. One of the most impactful changes is the $2,000 out-of-pocket maximum on covered prescription drug costs for both Medicare Part D and Medicare Advantage plans. The new cap is estimated to impact as many as 1.5 million Americans. Average monthly premiums for both stand-alone Part D and Medicare Advantage plans will also decrease slightly.
With the changing Medicare landscape, insurance companies are also making adjustments that may impact you. Some plans are no longer being offered, while others are making significant changes such as increasing deductibles, shifting to coinsurance rather than flat fees, or cutting ancillary benefits out of plans entirely. If your Advantage plan is eliminated, you must select a new plan, or you will automatically be enrolled back into the original Medicare plan for 2025, which could lead to unintended changes to coverages and costs.
It is important to understand the Medicare changes to ensure your existing coverage meets your needs or identify if you should switch plans. Make sure your selected plan covers any high-cost drugs you take, that your preferred doctor and other providers accept your plan, and that you are aware of and have funds available for potential additional costs. More information is available at www.medicare.gov, www.cms.gov, and resources such as AARP. As always, we are also here as a resource if you would like to discuss your options.
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