With the Medicare Open Enrollment period open, it’s essential to review your health plan options to ensure you’re getting the best care possible. MemorialCare offers a wide range of Medicare Advantage health plans, each designed to support your unique health needs. Whether you’re looking to reduce out-of-pocket costs, or seeking additional benefits like dental, vision, or chiropractic care, now is the perfect time to explore what’s available.
MemorialCare partners with various Medicare Advantage plans, combining Parts A and B (hospital and medical insurance) and including additional benefits like prescription drug coverage, dental, vision, and hearing. Medicare Advantage plans have an out-of-pocket maximum, offering financial protection against unexpected medical expenses.
Medicare Part C (Medicare Advantage) is an alternative to Original Medicare, offering additional benefits like dental, vision, and prescription drug coverage through private insurers. Medicare Part D is specifically for prescription drug coverage, helping to lower the cost of medications.
If prescription drugs are important to you, it’s crucial to understand the following changes coming to Medicare Part D in 2025:
- Out-of-Pocket Costs: Out-of-pocket spending will be capped at $2,000 per year. However, rates could rise, and some plans may only cover generic medications.
- Annual Base Premium: There is a cap on annual increases to base premiums, limiting them to 6% above the previous year’s amount. While this helps control the overall rise in base premiums, it does not restrict the increase of individual premiums. Some plans may choose to increase fees to offset those additional costs.
- Eliminating the Donut Hole: In 2025, there will be a three-phase benefit structure instead of the current four-phase system. Presently, enrollees pay 25% of the costs for both brand-name and generic medications. In 2025, patients will transition from the initial coverage phase to the catastrophic phase, meaning that some health plans could only offer generic drugs.
- Manufacturer Discount Program: The Coverage Gap Discount Program will conclude on January 1, 2025, and will be succeeded by the Manufacturer Discount Program – shifting more financial responsibility to health plans and drug manufacturers causing health plans to look for cost savings measures that inadvertently are passed down to the consumer.
- Drug Prices: Medicare will take an active role in selecting and negotiating prices for 15 specific Part D drugs, aiming to lower costs for beneficiaries and improve access to essential medications.
- Premium Stabilization: The program will limit monthly premium increases to approximately $2, helping beneficiaries better manage their healthcare costs while ensuring continued access to necessary medications.
If you’re already enrolled in a Medicare Advantage plan, it’s still worth reviewing your coverage during the Open Enrollment period. Many people overlook the importance of additional benefits like dental, vision, and hearing coverage and extras like gym memberships, transportation services, and even coverage for chiropractic care.
The Medicare Annual Enrollment Period (AEP) is now open until December 7. If you need help navigating the enrollment process or understanding the changes to Medicare, it’s important to act now. Call (877) 599-5622 to find a Medicare class nearby.