In a historic move for the Medicare program, out-of-pocket prescription drug costs will now be capped for the first time. Changes to Medicare Advantage plans or standalone Part D plans are set to begin on Jan. 1, 2025.
Paige Lombardo, co-owner of Health Matters Insurance in O’Fallon, Missouri, highlighted the upcoming change, stating that the notorious donut hole in Medicare’s annual gap in prescription drug coverage will be eliminated next year. Starting on Jan. 1, individuals will pay a maximum of $2,000 for their prescription drugs, potentially saving them thousands of dollars.
According to Leigh Purvis from AARP, the new out-of-pocket cap could lead to significant savings for more than 4 million Americans by 2029. On average, approximately 40% of individuals could save $1,000 or more once they reach the cap limit.
Lombardo emphasized the importance of reviewing the Annual Notice of Change (ANOC) that beneficiaries will receive in the mail, outlining any modifications to their plan, including copay adjustments. Understanding these details can help individuals anticipate and manage their healthcare costs effectively.
For those navigating Medicare enrollment, Lombardo suggested seeking assistance from free services offered by her company or similar organizations to ensure informed decision-making. It is crucial to explore all options and fully comprehend the Medicare program before selecting a plan.
Medicare open enrollment is scheduled from Oct. 15 to Dec. 7, providing individuals with the opportunity to make changes or enroll in new plans for the upcoming year.
