📋 Premiums for Medicare Drug Plans Will Be Less Next Year (AARP Article)

@SummerOnTheWay1 

Let me see if I can explain it and what I actually said.  

By law, the Inflation REduction Act, the BASE premiums can only go up 6% -

CMS.gov New RElease - Medicare Advantage and Medicare Prescription Drug Programs to Remain Stable as CMS Implements Improvements to the Programs in 2025 

per the link: 

• Premium Stabilization: Beginning in 2024, the Inflation Reduction Act provides a mechanism to limit premium increases for people enrolled in Part D. Specifically, the law limits the growth in the base beneficiary premium (used to calculate the plan-specific basic premium) to a 6% annual increase. 

Now that is the BASE premium  and a  base premium is just that a base onto which other amounts are added depending on what’s in the plan. what is in a premium?  The actual “meat” of the policy.  The actual “meat” of the policy is what makes it a benefit or a detriment based on ones needs.  

That’s what I am cautioning against - DON”T just look at the premium - look at the meat of the policy - what’s covered, for how much, what tier, what deductible.  Those are the things that can be designed and sanctioned by CMS. to meet the base premium.  

Things like this will reduce the cost of the plan to a beneficiary but it may also take away some of their needs too:

• A needed expensive drug may not be in the formulary anymore
• A needed drug has been pushed up to a higher more expensive tier
• The deductible might be way higher
• copays may change to coinsurance

Or the plan may have just disappeared altogether.  

So what everybody should do is review their current plan in detail based on ones needs when they get their EOC (explanation of change).

Then when the new plans come out for your area, beginning soon, compare your needs to the other plans to see if you would come out better with another plan.

When the government ask insurers to pick up more, they do but it is then the cost is just passed along to the beneficiaries.  Fact of Life like everything else, low man on the totem pole pays.  

This cautionary review shouldn’t just be for free standing drug plan.  As you may or may not know, the majority of Medicare Advantage plans have an included Medicare Prescription Drug Plan.  So review the one that you have - free standing Prescription Drug Plans or a Medicare Advantage plan.

My caution is posted here on this board:

https://community.aarp.org/t5/Medicare-Insurance/PLEASE-REVIEW-YOUR-MEDICARE-COVERAGE-FOR-2025/td-p/2568330 

To buy any insurance product, you have to know your needs, your pocketbook and then you analysize the details of the policy based on those factors.  They may throw in some “free’ (HA_HA) stuff but that’s just fluff.  And some MA plans are reducing that fluff, whatever it may be.  

Now would I ever tell you that I don’t believe the government?  Not unless I can prove it without a shadow of a doubt.  Do I have doubt ?  Well . . . . . 

@SummerOnTheWay1   Nicole, please take the time to check out your options.  I know it is easy to just keep what you have.  But for me that would cost a lot of money.

I received an email from Medicare today that had a preview of the Part D plans in my area.  I entered my information (zip code, county, drugs, and nearby pharmacies).  If I stick with my current plan it will cost me roughly $1080 for the year (premiums + prescriptions) 

There are 5 other plans that are less expensive.  Hopefully this will be accurate when the enrollment time comes.  The least expensive has a $0 per month premium and all 3 of my prescriptions are $0 per month copay.  So I would pay $1080 if I stay with the current plan  or I could switch and pay $0. 

It isn't that hard to switch.  You can do it online on the Medicare site that compares the plans.  My husband switched last year and it was pretty easy.  In fact the plan he currently has is the plan I will be switching to.  He takes no prescriptions so he always chooses the lowest priced premium.  Last year even though it had a lower premium than my current plan the total cost for the year (premium + prescriptions) was higher than my current plan.  

Oh yes and CVS is a preferred provider here.  Also Walgreens.  All the others nearby are in network but not preferred so they would cost a little more for the prescriptions since they are preferred.  I hope you check and find something that will work better for you too.

@SummerOnTheWay1   ;  It looks like the Wellcare for me too.  The next least expensive would cost me about $42 a month (premium + drug cost).  Wellcare would cost $0.  Hopefully they aren't sucking us all in and then raise the price of the drugs after sign-up.  They can raise their prices whenever they want but we aren't allowed to change plans until the next year.  Somehow that doesn't seem fair.  But I have that $42 savings to put towards the drugs if they raise their prices.

I will be waiting to sign up after I get back from vacation next week.  Just want to make sure they don't make any changes.

Kaiser Health News 10/21/2024 - Medicare Drug Plans Are Getting Better Next Year. Some Will Also Cost More. 

Course, that's for people that take expensive drugs - those are covered and better due to the MOOP for PDPs.

But for others that may one or two and these are generic - it's gonna hurt a bit but that's what insurance is - 

@SummerOnTheWay1 , It should work out for you.  My husband was on this last year and continuing this one for next year.  I also switched to this.  Zero premium and Zero cost for the medications. 

I have received my card and signed up for an account on their website.  It shows my premium is $0.  So that is a good start. The government must give them a certain amount of money like they do for Medicare Advantage plans.  Otherwise I don't see how they could do this for ZERO $$$$.

I won't need a refill until February as I just had mine refilled for 3 months last week.  I figured might as well since the cost on my current plan is also $0 for the prescriptions.  My premiums aren't $0 this year but still only $9.90 and I have to pay that if I have a prescription or not. It will give me a little time to see what happens next year. 

@SummerOnTheWay1 wrote

iI finally sat down and READ the "printout" the LOA lady gave me.

Hmmm, concerned about the IF YOU ARE ELIGIBLE TO JOIN. 

===============================

That just means that

You are 65 years old or have Medicare because of a disability

You are signed up for Medicare Parts A and B and

You have chosen to get your benefits via Traditional Medicare and NOT a Medicare Advantage plan.

If a person signs up for a Free standing Medicare Part D plan, it might UNENROLL them from a Medicare Advantage Plan unless it is a plan specifically for veterans with VA drug coverage.

Sounds like you are fine.  No premium, lots of preferred pharmacies, perhaps with only Tier One $0.00 copy meds.

Wow!  So it hasn't changed in you Medicare Account?  I got a letter in the mail from Aetna after I get my prescription card from WellCare.  I found my disenrollment letter in the Plan Benefit Documents on the Caremark site. It says it was sent October 25.  That was the day before WellCare sent their letter.  

I did my change directly through the Medicare site used for looking for plans for 2025.  I clicked on the button to enroll and answered the questions there.  Printed it up and everything went well.  Maybe the person helping you didn't put the change in the day you were there.  I don't think she was in your Medicare account because you would have had to give her your password.  Maybe it takes a little longer doing it that way.  It did say it could take up to 10 days to show up in your account.  I would definitely be getting in touch with the person who helped you if it is not in your Medicare Account by Monday. 

Hopefully it is just a delay, since you didn't do it directly on the Medicare site.  I guess someone from Medicare would have to enter the change, which might be the delay.

I am glad I did it directly like we have in the past.  It was so easy.  Hopefully things are going to work out.

Glad everything is now in order for you.  I wouldn't worry about them going out of business.  We had a WellCare prescription plan back in 2020.