The Medicare Open Enrollment Period, from October 15 through December 7, is an important time to review and compare your coverage options for the upcoming year. This year’s Open Enrollment is particularly significant due to changes in Part D protections under the Inflation Reduction Act.
Key reforms include the elimination of the coverage gap, a $2,000 cap on beneficiary out-of-pocket costs, and the creation of an optional payment plan program(M3P). These changes, along with existing reforms such as the $35 cap on out-of-pocket costs for insulin products and the expansion of the Low Income Subsidy program, emphasize the importance of carefully comparing coverage options.
While all Medicare Advantage plans must cover all services covered by Original Medicare, and all Part D plans must provide coverage for all medically necessary Part D drugs, costs and structures can vary greatly. Comparing plans during Open Enrollment allows you to select the coverage that best suits your health, financial needs, and preferences.
Despite the importance of careful shopping, nearly 7 in 10 beneficiaries did not compare their current coverage with other options in their area in 2021.(KFF study)
Reach out for local assistance through Intgerity Health Advisors:
www.integrityhealthadvisors.com
720-288-0863
Your local brokerage can help you compare coverage options, understand plan designs and costs, and determine the best fit plan for 2025.
The structural changes brought about by the Inflation Reduction Act, particularly the $2,000 out-of-pocket cap and the simplification of the Part D coverage phases, are critical updates designed to limit unpredictable out-of-pocket costs. These changes highlight the importance of considering all aspects of plan design and costs when evaluating plan options.
Additionally, the new, optional Medicare Prescription Payment Plan (MPPP or M3P) allows people to spread their Part D out-of-pocket costs over the calendar year. This program may benefit those who expect to reach the out-of-pocket cap or who take high-cost medications for limited durations.
By taking advantage of the resources available during Open Enrollment, you can make informed decisions about your Medicare coverage and ensure that you have the plan that best meets your individual needs and circumstances.
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