We explain, in understandable terms, how insurance works for you.
We explain, in understandable terms, how insurance works for you.
Legislation that takes effect in 2025, is changing the medicare landscape. Somewhat. We are perfectly willing to discuss these changes with you.
Medicare is continuing its changes to the PART D benefits which will be finalized in mid-late September. The effect of these changes will effect all PART D coverages regardless if PART D coverage is bundled within a Medicare Advantage Plan or a standalone PART D drug plan (aka PDP). In the bundled plans (MAPD) the company can decide how to handle the changes. In turn, you can decide whether or not to accept those changes or change your coverage.
All companies must have the benefits that Medicare mandates they offer. What they can change, however, is the amount of those benefits the beneficiary pays.
For 2025, the annual out-of pocket risk of the beneficiary is reduced...greatly. The coverage gap ('doughnut hole') is abolished. The catastrophic coverage continues as it was in 2024 where there is no co-pay.
These changes affect the cost of the drugs all along the supply chain...You, the plan, the manufacturer.
So. Adjustments need to be made.
The companies can change cost shares, change the drugs offered or, they can adjust the coverages the plan offers that are not covered by Medicare but offered as incentives to purchase the plan.
Whatever decisions the company makes, the company must continue to generate a reasonable profit. Or Close.
How does the adjustment affect your annual cost risk. Recall the primary purpose of any plan is to provide coverage to enhance your well-being.
Consider your position. If you are happy with your company and the changes do not appreciably affect your annual risk of cost, maybe the best decision is to stay as is.
All this is in flux as Medicare finalizes change in September.
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