By Mark Miller in the NYT
Americans on Medicare will see big, and welcome, changes next year. The program’s prescription drug insurance will be much stronger — and easier to understand — as a result of the Inflation Reduction Act of 2022.
But the changes make it all the more important to review your coverage options during Medicare’s annual enrollment period, which is happening now and runs through Dec. 7.
Prescription drug and Medicare Advantage plans are revising their offerings more than usual for 2025 because of changes required by the Act. The legislation strengthens prescription drug coverage substantially by imposing a hard $2,000 cap on total out-of-pocket spending for drugs covered by your plan.
The law will provide thousands of dollars in relief to beneficiaries who take high-cost drugs for conditions like cancer and multiple sclerosis, and it will give seniors greater predictability in planning their health care spending.
But the plan you’re in for 2024 may not be the best fit next year. Your premium and deductible might actually rise as insurance companies react to the changing rules, and a plan’s list of covered drugs might change.
If you are enrolled in traditional Medicare Part A (which covers hospitalizations) and Part B (outpatient visits) and have a supplemental Medigap policy, there’s no need to review that coverage. But stand-alone Part D prescription plans should be re-evaluated. And if you have chosen Medicare Advantage as an alternative to traditional Medicare, it makes sense to re-evaluate this coverage, too, since many of these plans include drug coverage.
“People need to be on high alert this year for changes to whatever type of private Medicare plan coverage they have,” said Philip Moeller, author of the book, “Get What’s Yours for Medicare.”
“Everyone needs to be especially vigilant,” he said.
The 2025 changes join other cost-containment provisions of the Inflation Reduction Act that have already been phased in, including a $35 monthly cap on the cost of insulin for diabetes patients and, for low-income seniors, free vaccines and expanded eligibility for financial assistance with Part D costs.
Here’s a look at how private plan offerings will change in 2025, and what to look out for as you shop for coverage. (continued on page 2)