October 2024
Financial Planning

Let’s Talk Medicare 2025

By Myra Alport, AFC®

The sounds and scents of fall are in the air. With autumn comes shorter days, leaves bursting into gorgeous hues of orange, red and yellow, pumpkin lattes and…the long-awaited announcement of some significant changes to Medicare for 2025.

Let’s look at what’s on the docket for Medicare 2025.

Part D (Prescription Drug) Spending Cap Change

The infamous Medicare “donut hole” will be replaced by an annual out-of-pocket cap of $2,000. That means that when the combination of meeting your Part D deductible, co-pays and co-insurance adds up to $2,000 you will pay nothing further for the rest of the calendar year. Uncovered drugs are excluded.

The new cap applies to Medicare and Medicare Advantage Part D plans.

New Part D Payment Plan Option

The introduction of a new Part D payment plan allows you to spread your out-of-pocket drug costs across the calendar year (January-December) to help manage your monthly cash flow. You will continue to pay your Part D premium (if applicable), copays and co-insurance expenses; however, you will receive a bill from your drug plan instead of paying the pharmacy.

Participation in this payment option is entirely voluntary.

Weight Loss Drugs

Part D plans will cover popular weight loss drugs when they are ordered for medical diagnoses such as diabetes and cardiovascular disease.

Mental Health Provisions

If you have been paying for mental health services out of pocket, thousands of licensed marriage and family therapists, mental health counselors, and addiction counselors will be eligible to enroll as Medicare providers. Always verify with your provider if they accept Medicare.

Medicare Advantage Plan Midyear Statement

Medicare Advantage plan holders will receive a midyear statement that will show unused benefits such as dental, vision, hearing or fitness.

Extended Caregiver Training Support

Medicare will cover costs related to caregiver training if a healthcare provider determines that such training is appropriate for a patient’s treatment plan. There is also the expansion of a new pilot program for dementia patients and their caregivers.

Summary

Each year it’s important to revisit your list of prescription medications to make sure they are covered by your current plan. Your Part D premium may increase or decrease based on changes to deductibles and drug formulary tiers.

Personal note: Last year my Medicare agent informed me that one of my prescription drugs was dropped from my plan going forward. Fortunately, he was able to find a new Part D plan that covered this medication. It definitely pays to be proactive!

Protect Yourself from Medicare Fraud in These 3 Ways

1. Never give your Medicare Number to anyone except your doctor or trusted parties. Medicare will never randomly call/text/email you to request your Medicare Number or personal information.

2. Review your Medicare Summary Notices for any unusual charges for services or products you did not order or receive.

3. Report fraudulent activity by notifying Medicare at 1-800-633-4227. Learn more on the Medicare website here.

MARKET UPDATE
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To download the October 2024 Newsletter: CLICK HERE

This commentary reflects the personal opinions, viewpoints and analyses of the Copperwynd Financial, LLC employees providing such comments and should not be regarded as a description of advisory services provided by Copperwynd Financial, LLC or performance returns of any Copperwynd Financial, LLC client.

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