The Inflation Reduction Act (IRA) introduces significant changes to Medicare, impacting coverage options, costs, and out-of-pocket expenses for beneficiaries. At Korhorn Financial Group, we want to ensure you understand these changes and take proactive steps to review your Medicare coverage for the 2025 plan year. Here’s what you need to know:
Key Changes to Medicare Under the Inflation Reduction Act
- Lower Drug Costs with New Price Negotiations
Starting in 2026, Medicare will negotiate prices for certain high-cost drugs. This groundbreaking change aims to lower costs by targeting some of the most expensive medications on the market, potentially saving beneficiaries hundreds or even thousands of dollars annually. - $2,000 Annual Out-of-Pocket Cap: What It Means for You
A major win for some Medicare Part D beneficiaries is the introduction of a $2,000 annual cap on out-of-pocket spending in 2025. This change provides significant financial relief for those with high prescription drug costs, helping beneficiaries manage healthcare expenses more effectively. - Expanded Financial Assistance: Could You Qualify?
Starting in 2024, more beneficiaries will be eligible for the Low-Income Subsidy (LIS) program, which helps cover premiums and out-of-pocket costs. This expansion means greater financial support for those who need it most. If you think you might qualify, now is the time to explore your options. - Insulin Costs Capped at $35 Per Month
For those managing diabetes, the IRA caps insulin costs at $35 per month for Medicare Part D beneficiaries, effective from 2023. This change could lead to substantial savings and more predictable healthcare costs for insulin-dependent beneficiaries. - Say Goodbye to the “Donut Hole” Coverage Gap
The coverage gap in Medicare Part D, often referred to as the “donut hole,” will be fully closed. This will simplify costs and reduce financial burdens, ensuring that beneficiaries pay a more predictable share for their medications.
How Will These Changes Affect You?
With these changes coming into effect, it’s crucial to understand how they may impact your current Medicare coverage. Here are key reasons why you should review your plan for 2025:
- Prescription Drug Plans Could Change
Changes in drug price negotiations and the new out-of-pocket spending cap may result in adjustments to plan premiums, formularies, and network pharmacies. A review can help you determine if your current plan remains the best option for your needs. - New Cost Structures Require Strategic Planning
With the $2,000 cap on out-of-pocket spending, managing your drug costs will require a new strategy. Reviewing your Medicare Advantage or Part D plan options for 2025 can help you adapt to these new structures and potentially save more. - Expanded Eligibility: Could You Now Qualify for a Subsidy?
The expanded LIS program means more people can receive help with premiums, deductibles, and copayments. A coverage review can help you find out if you qualify for this valuable assistance. - Annual Plan Changes: Don’t Be Caught Off Guard
Medicare plans change their benefits, premiums, and networks each year. With the IRA’s broad policy shifts, it’s even more important to compare plans during the Annual Enrollment Period (AEP) to ensure your coverage aligns with your needs.
Don’t Miss Out on Savings and Benefits for 2025
The changes brought by the Inflation Reduction Act present an opportunity for Medicare beneficiaries to save on healthcare costs and enhance their benefits. However, these changes also require a proactive approach to ensure you are on the right plan for 2025.
How Korhorn Financial Group Can Help You Navigate These Changes
At Korhorn Financial Group, we understand how overwhelming it can be to navigate changes to Medicare. Our independent Medicare agents are here to assist you:
- Get a Personalized Medicare Coverage Review
We provide tailored reviews of your Medicare coverage and explore alternatives to help you make informed decisions about your health and finances. - Access Our Educational Resources and Expert Guidance
Stay informed with up-to-date resources and insights on Medicare policy changes and what they mean for you. - We’re Here for You All Year Round
Our team is available to answer your questions, provide guidance, and support you in making the best choices for your health and financial well-being.
Take Action Today: Schedule Your Medicare Review
The Inflation Reduction Act marks a turning point for Medicare, potentially saving beneficiaries money and improving access to care. To make the most of these changes, it’s crucial to review your Medicare coverage options for 2025. Contact Korhorn Financial Group today to schedule a no-obligation Medicare review and ensure you have the best plan to fit your needs.
Ben Bulgrien is a Health Insurance Advisor at Korhorn Financial Group. He holds his Fellow, Health Insurance Advanced Studies (FHIAS®) designation.
