📋 Medicare Is a Lifeline — AARP Is Fighting to Protect It (AARP Article,Advocacy)

[Winter2025VA]

FROM THE ARTICLE.

By Nancy LeaMond, AARP. Published July 15, 2025.

For nearly 60 years, Medicare has been the cornerstone of health and financial security for millions of older Americans. It’s a fundamental promise: after a lifetime of hard work, you’ll be able to get the care you need, when you need it.

At AARP, we’re fighting every day to make sure that promise is kept.

Whether it’s hospital coverage, doctor visits, prescription drugs, or preventive care, Medicare is essential to helping older Americans live healthier, more independent lives. But the system isn’t perfect, and as health care evolves, so must Medicare. That means protecting what works, fixing what doesn’t, and ensuring every part of the program is delivering for the people it’s meant to serve.

USE THE LINK BELOW TO READ THE ARTICLE.

https://www.aarp.org/advocacy/blog/medicare-is-a-lifeline-aarp-is-fighting-to-protect-it.html

[MichaelP494024]

PLEASE BE AWARE!  Covid is spreading out here and Medicare no longer covers Paxlovid. On March 3, 2025, without notifying anyone, Medicare no longer covers this life-saving drug - cost is $1500!  I contracted Covid 10 days ago. Doctor prescribed Paxlovid. I am 74 years old and this could be life-threatening. After running through my insurance I still paid $722!  I asked the pharmacist what people do - response - most people walk away and hope they can recover, others wait until they are so sick they go to the ER, others die. It is hard on the pharmacists to see this. Why do we have elected officials - to make them money while we die!  A million people died from the last outbreak. We need to fight back against these thieves!  

[GailL1]

It should have been covered in your Part D plan.  Yes, they did notify people - all over the news - COVID 19 Pandemic status ended.

There are some coverage options if you were eligible. 

CDC.gov- 06/11/2025 - COVID-19 Treatment Clinical Care for Outpatients 

from the link ~

Access to COVID-19 Treatment

Patient assistance programs

Patient assistance programs that help pay for COVID-19 antivirals are available to people who are underinsured, uninsured, or certain people who are publicly insured through Medicaid, Medicare, or other programs. Manufacturer access programs that support COVID-19 treatments such as PAXCESS (Paxlovid), including the U.S. Government Patient Assistance Program (USG PAP) operated by Pfizer, Merck Helps (Lagevrio), and Gilead Advanced Access (Veklury), are also available. A prescription is needed to enroll in these programs; therefore, patients should seek medical care as early as possible if they develop symptoms to avoid delays in starting treatment.

Updates to the Patient Assistance Program for 2025

Beginning March 1, Medicare patients who are underinsured might be eligible for no cost Paxlovid. In addition, certain patients who are uninsured or are covered by Medicaid, Tricare, or the Veterans Affairs Community Care Network can access Paxlovid through a patient assistance program if they cannot afford the medication. Uninsured and underinsured individuals may still receive no-cost Paxlovid through the USG PAP until the U.S. government's supply is depleted or until December 31, 2028, whichever comes first.

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From what I have read, Pfizer, who runs this program says it is available for sure thru 12/31/2025.

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GOODRX - Paxlovid - Medicare Coverage  

All Medicare Part D plans cover Paxlovid - Tier 3- so yes, it is expensive - it is a brand name drug for now.  

Covid19 is no longer a pandemic and with that designation, those added benefit coverages have gone away.  

You can still get the vaccine at your pharmacy but people now have to pay for the test and the treatment.

If you used your Part D plan coverage for your Paxlovid Rx, this will be included in your total out of pocket cost for 2025 - so a portion of the $ 2000 max.  

You didn’t give any details on how your plan covered it - did you have to meet your deductible with this medication?  Was there a substantial co-pay connected to it?  

Would you have qualified for the Pfizer USG PAP (Pfizer US Government Patient Assistance Program) ?  Maybe not - I would have thought your pharmacist would have at least mentioned it to you.

[Winter2025VA]

Michael @MichaelP494024 , I am so sorry you had gotten COVID. Never had it and hope to never. Yes, here in my area of Virginia, there have been cases. But still there are folks setting up indoor mass events. Nope, at age 67 I am staying home. I do keep up on my vaccines and limit my time in group settings. Take care, Nicole!

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@MichaelP494024 wrote:

PLEASE BE AWARE!  Covid is spreading out here and Medicare no longer covers Paxlovid. On March 3, 2025, without notifying anyone, Medicare no longer covers this life-saving drug - cost is $1500!  I contracted Covid 10 days ago. Doctor prescribed Paxlovid. I am 74 years old and this could be life-threatening. After running through my insurance I still paid $722!  I asked the pharmacist what people do - response - most people walk away and hope they can recover, others wait until they are so sick they go to the ER, others die. It is hard on the pharmacists to see this. Why do we have elected officials - to make them money while we die!  A million people died from the last outbreak. We need to fight back against these thieves!  

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[Winter2025VA]

2026 and THIS YEAR's open enrollment (October to December) will be interesting for me. I have Traditional Medicare with Part D with Wellcare. Totally HAPPY with this setup for 2 years now. Had another provider [Aetna] my 1st year and switched when they decided to delete my "cheap" plan. So far ZERO cost to me from Wellcare. Hope that repeats for 2026. Also hoping my 2nd Medicare Doctor sticks around. Lol, started Medicare 2 years ago & that 1st year was stressful [lost my totally awesome doctor (she left Medicare practice) & my Part D provider upped my plan cost].  I would luv to hear about your MEDICARE JOURNEY!!! Take care, Nicole (Friends & Family Forum)

[GailL1]

You probably also hope that you can still qualify for the Medicare Savings Program (MSP) to pay your Part B premiums and anything else that the program you are in covers - deductible, copays, coinsurance, extra help.

A high COLA might push beneficiary’s income too high now or in the future to be eligible for the MSP.  And Part B premiums are getting higher - the current Trustee report estimates the 2026 Part B premium at over $ 200 a month.  We will know the actual Medicare premiums as well as the new Medicare deductibles in October when the 2025 usage is computed.  

[Winter2025VA]

@GailL1 , no I am not concerned about the 2026 Extra Help Program. As I had stated in a prevous post - Virginia put me in the program. I didnot know about it & my Part B Premiums were coming out of my Retirement Social Security direct deposit before I got it. All of my life I have done what is needed to keep a roof over my head legally. As far as COLA, again, I NEVER count on that to change my life as we may or may not get one. Either way, my life will continue as it is = live below my means & debt free. Take care, Nicole!