Medicare folks: Annual Enrollment Period is Here

By Dave at Trout Insurance

ANOC…ANOC… WHO’S THERE?

Yes, it’s that time of year again for us Medicare folks – Annual

Enrollment Period (AEP). And, we will have significant changes for plan year 2025.

Medicare plans come in several favors:

Medicare Advantage Plan Drug

(MAPD) plans for Medical, Rx and More.

Medicare Advantage Medical

Only plans; these plans do not include prescriptions.

Dual Medicaid

Medicare Plans or Chronic Disease Special Needs Plans - these are like MAPD’s for folks who qualify based on their individual status.

And - Medicare Prescription Drug Plans (PDP) - These are stand-alone plans sold separately; often paired with a MediGap Supplement or they can be embedded into a MAPD. These cover Rx prescription medications approved by Medicare.

That’s where your ANOC comes into play. “Annual Notice of Change”. You will receive this if you have any of these Medicare Plans above.

Review your ANOC (Annual Notice of Change) very, very carefully. Plan premiums, deductibles, copays, maximum out of pocket, formularies of covered drugs, networks of doctors and hospitals and the details of the extras will all be changing.

This ANOC letter will specify what your plan you had in 2024 will look like in 2025 –but only if you keep that exact same plan.

Look for your ANOC in September.

For 2025 - we will see BIG changes in the PDP. I was present at the creation of these plans back in 2005 under President Bush, these changes reflect the improvements by President Biden under the Inflation Reduction Act, 2022. Gad – that’s 17 years. Bottom Line – EVERY PDP will be changing: better and simpler.

PDP plans for 2025 will have a deductible of $590.00 Many plans will waive all or part of that cost for generic or lower cost medications. During the next stage, we’ll pay a copay or 25% of the cost of those drugs.

When your “Out Of Pocket” (OOP) is equal to $2,000.00, then your covered Rx’s will be paid at 100%. Be sure to check your medications and confirm if they are on the formulary (list of covered RX) of the insurance company. And if your preferred pharmacy is working with that company to offer you lower costs.

In addition, all plans must offer the option to pay out-of-pocket RX costs in monthly installment payments instead of all at once at the pharmacy if you have a deductible. This will be a benefit for many seniors on a fixed income.

WOW-That’s a heck of Knock:Knock–but it’s No Joke.

There are resources to help you. Check out Medicare.gov or local NC Shiip office. All insurance agents who work with Medicare are required to have taken training on all these rules changes and the details for each individual plan they represent.

Check out our website at Troutinsurace.com or Medicareoptionsforyou.com for more information and resources.

David, Idelle and Dave at Trout Insurance are ready to work with you to find the most effective plan to meet your needs, budget and values.