October 7, 2024 – The Medicare Annual Enrollment Period (AEP) is the time each year when Medicare beneficiaries can make changes to their Medicare coverage. AEP runs from October 15th to December 7th, during which beneficiaries can:
- Switch from Original Medicare to a Medicare Advantage Plan or vice versa.
- Switch from one Medicare Advantage Plan to another.
- Enroll in, switch, or drop a Medicare Prescription Drug Plan.
Changes made during AEP take effect on January 1st of the following year. If you’re on Medicare, this period is crucial for you to review your current plan, compare options, and ensure you have the best coverage for your needs.
What’s Changing This Year?
Changes to Doctor Networks
Most of the major insurance carriers have been revising their provider networks as we head into 2025, so it’s important that you make sure all of your doctors will still be in the network. A local insurance advisor such as myself can help you with this.
Prescription Drug Savings
- There is now a $35 monthly cap on out-of-pocket costs for insulin for Medicare Part D enrollees. This cap applies even before beneficiaries reach the catastrophic phase of their coverage, making insulin more affordable for seniors.
- Starting in 2025, your total out-of-pocket prescription drug costs won’t exceed $2,000 annually. This is a significant change, as there is currently no limit on out-of-pocket spending. Once you reach the $2,000 threshold, you won’t pay anything further for your prescriptions for the rest of the year.
- You will also be able to break your prescription costs into monthly installments rather than having to pay everything upfront, which helps if you’re on a fixed income.
Monthly Premiums
If you’re on a Medicare Supplement, you might be due for a premium increase. If this becomes unaffordable for you, there are alternative options available. Some of you may be on a Medicare Advantage plan offering a Regional PPO with a monthly premium. You may find that your monthly premiums will be increasing in 2025.
How Can You Be Prepared for AEP?
With so many plans to choose from, it can feel overwhelming. Here are a few tips to help you make an informed decision:
Review Your Current Plan
What do you think about your current plan? Has it met your financial and health needs this past year? Maybe your prescription drugs were too expensive or you had a doctor that was out of network. Make a list of pros and cons.
Consider Your Budget for Next Year
Healthcare costs are the #1 concern for most seniors, so we want to make sure that your Medicare plan offers you the best financial protection. Look beyond the monthly premium and consider the overall cost.
List Your Prescriptions and Doctors
Before you think about extra perks (such as fitness or dental benefits), it’s essential to make sure your doctors and prescriptions will be covered in 2025. List these out so you can look at plans that cover them.
Ignore TV Commercials and Ads in the Mail
Unfortunately, there are a lot of bad actors in the Medicare industry who are just trying to make money off of seniors. Many of them operate from call centers overseas! My advice: ignore the advertisements altogether.
Meet with a Local Insurance Advisor
Did you know it costs $0 to work with an independent insurance advisor such as myself? Why do this alone when you don’t have to? By meeting with a local expert, you can rest assured that you have made the best plan choice for your needs.
Gillan Boyer is an independent insurance advisor serving Sulphur Springs and the surrounding areas. You can reach him at 903-307-3644 or callboyer.com.
