Medicare is cutting back on what it pays Insurance companies in 2025 for services performed. But that may well cost us users more!
But now for what could be the good news!
1) A piece of 2022 legislation, from the Inflation Reduction Act of 2022, is possibly lowering your drug costs. If you buy insulin, starting in 2022 your prescription which had been trending up to $100 a month was limited by this new federal law to $35. That sounds good! (But wait, who is picking up those once paid costs? Yeah, you know! And those costs didn't just die a natural death. Where will is show up?
2) 2ndly, in 2024, some changes in how Medicare handles those with huge drug expenses, who go past the DONUT HOLE and fall into "Catastrophic" coverage with over $8,000 of out of pocket costs, have found some relief in their very high ticket costs and some relief in lowering their total yearly payouts. They are getting some relief in 2024, due to said legislations. This affects a low percentage of people but this help for them may be an actual life saver!
3) This one is the show stopper. And it will help many people in 2025. There will be for the first time a $2000 maximum on out of pocket, pharmacy costs for Medicare users. OK, this is huge. Remember that "drugs in hospital" is a Part B item, covered at zero on my supplements and up to the MOOP on Advantage plans. But this maximum could save many people money. You think this is probably rare to spend this much. Not if you are 70 or over with a handful of NAME BRAND meds. Or maybe just Ozempic? Mounjaro? Eliquis?
4) And finally, Catastrophic Coverage will not exist in 2025 !! We have had 3 price ranges to be charged by: 1) initial Coverage, everyone starts the year in it 2) The Coverage Gap, known not affectionately as the DONUT HOLE and finally, not somewhat rarely used for those that spend on $8,000 a year on the medications, And finally Catastrophic Coverage, will be eliminated in 2025. It used to bill you 5% of you a drugs LIST PRICE. So all four issues appear to improve the life of Medicare drug users.
But just one thing! Who will pay those costs? Where will they show up? Will have more later, enough for today. Do you need help?
As always, if you are turning 65 this year, already turned 65 and would like to have me review what you got (you may still be able to change plans in the first 6 months), would like to lower your monthly supplement pricing by rewriting your plan (works if you pass, according to the health companies questions), just hate your current plan, etc. Email me at ges01@comcast.net / or call me at 713-376-5608 / Please provide a phone no. on any message as I don't plan to type for hours to learn your situation / I was Formerly a paying sponsor on OB for many years, and have routinely helping those with health insurance needs / Posting on this site since 2006 / I am an Independent agent representing most major brands / There is no fee ever for any help I provide / Always the lowest rates in Texas, Medicare only allows one price! / I currently work with 450 or so Medicare clients with some of your OB friends in attendance.
Gary / (Insurance Horn) email me anytime of the day or week / or call me 12PM to 6PM weekdays at 713-376-5608
But now for what could be the good news!
1) A piece of 2022 legislation, from the Inflation Reduction Act of 2022, is possibly lowering your drug costs. If you buy insulin, starting in 2022 your prescription which had been trending up to $100 a month was limited by this new federal law to $35. That sounds good! (But wait, who is picking up those once paid costs? Yeah, you know! And those costs didn't just die a natural death. Where will is show up?
2) 2ndly, in 2024, some changes in how Medicare handles those with huge drug expenses, who go past the DONUT HOLE and fall into "Catastrophic" coverage with over $8,000 of out of pocket costs, have found some relief in their very high ticket costs and some relief in lowering their total yearly payouts. They are getting some relief in 2024, due to said legislations. This affects a low percentage of people but this help for them may be an actual life saver!
3) This one is the show stopper. And it will help many people in 2025. There will be for the first time a $2000 maximum on out of pocket, pharmacy costs for Medicare users. OK, this is huge. Remember that "drugs in hospital" is a Part B item, covered at zero on my supplements and up to the MOOP on Advantage plans. But this maximum could save many people money. You think this is probably rare to spend this much. Not if you are 70 or over with a handful of NAME BRAND meds. Or maybe just Ozempic? Mounjaro? Eliquis?
4) And finally, Catastrophic Coverage will not exist in 2025 !! We have had 3 price ranges to be charged by: 1) initial Coverage, everyone starts the year in it 2) The Coverage Gap, known not affectionately as the DONUT HOLE and finally, not somewhat rarely used for those that spend on $8,000 a year on the medications, And finally Catastrophic Coverage, will be eliminated in 2025. It used to bill you 5% of you a drugs LIST PRICE. So all four issues appear to improve the life of Medicare drug users.
But just one thing! Who will pay those costs? Where will they show up? Will have more later, enough for today. Do you need help?
As always, if you are turning 65 this year, already turned 65 and would like to have me review what you got (you may still be able to change plans in the first 6 months), would like to lower your monthly supplement pricing by rewriting your plan (works if you pass, according to the health companies questions), just hate your current plan, etc. Email me at ges01@comcast.net / or call me at 713-376-5608 / Please provide a phone no. on any message as I don't plan to type for hours to learn your situation / I was Formerly a paying sponsor on OB for many years, and have routinely helping those with health insurance needs / Posting on this site since 2006 / I am an Independent agent representing most major brands / There is no fee ever for any help I provide / Always the lowest rates in Texas, Medicare only allows one price! / I currently work with 450 or so Medicare clients with some of your OB friends in attendance.
Gary / (Insurance Horn) email me anytime of the day or week / or call me 12PM to 6PM weekdays at 713-376-5608
