On Medicare? This Article Is a Must Read: Major Medicare Changes for 2025, So It is Very Important to Review Your Policies During the Open Enrollment Period

First, the good news. Seniors using Insulin now have their costs capped at $35 each month. This has already made a huge difference for those living with Diabetes. Starting next year, seniors’ yearly out-of-pocket Part D drug costs will be capped at $2,000. Seniors will also have the option to spread these costs out over the entire year through a new program called the “Medicare Prescription Payment Plan.” Both of these changes can help seniors who rely on multiple brand-name medicines and those on fixed incomes.

Now the bad news: because of the law, many insurers have shifted some medications to “non-preferred” or “specialty” tiers that require higher out-of-pocket costs, restricting beneficiaries’ access to previously covered drugs. Some insurers have also created rules that make it harder to get the drugs your doctor recommends, like making patients first try cheaper options. It is important that seniors learn about these changes — and the impact they will have on their access to medicines.

As we approach the Medicare annual enrollment period, it's essential to equip yourself with the knowledge and resources to make informed decisions about your healthcare coverage. It is best to work with a licensed agent to help navigate these complex changes. My name is Carol Foley, and I am a licensed insurance agent, Medicare specialist, and small business benefits counselor with over 25 years of experience. Our offices are conveniently located right here in Hallandale. The best part – Our services come at no cost to you.

We can assist you with Medigap plans, Medicare Advantage plans, Part D prescription drug plans, dental, vision, hearing plans, gap insurance, Cancer policies, long-term care, life insurance, and final expense coverage. Our offices are open 7 days a week during open enrollment, staffed from 8am-8pm. We are also happy to come to your residence if you prefer a home consultation.

How to make the most of Medicare Open Enrollment:

Medicare Open Enrollment occurs from October 15 to December 7 each year. This window offers beneficiaries the opportunity to review and make changes to their Medicare coverage. There are several compelling reasons why this period demands your attention:

Plan Review and Comparison: During open enrollment, Medicare beneficiaries can assess their current Medicare plans, including Original Medicare (Part A and Part B), Medicare Advantage, and Prescription Drug Plans. Comparing plans can help you find better options tailored to your specific needs.

Medicare Supplement Price Shopping: Did you know that all supplement plans are standardized? Plans like F, G, or N offer identical coverage, so why do prices differ so significantly among carriers? Open enrollment is the perfect time to price shop and secure the best pricing for your chosen plan.

Changes in Health Needs: Health requirements can change over time. During open enrollment, beneficiaries have the opportunity to evaluate whether their current coverage adequately meets their evolving healthcare needs.

Cost Savings: Medicare plans can alter their premiums, deductibles, copayments, and coverage from year to year. Beneficiaries can potentially find cost-effective options that better align with their financial circumstances.

Network Changes: Medicare Advantage plans come with provider networks. Beneficiaries should verify whether their preferred doctors and healthcare facilities remain in-network with their chosen plan.

Plan Ratings and Quality: Medicare assesses the quality and performance of healthcare plans, including Medicare Advantage and Part D prescription drug plans. Utilize open enrollment to select plans with higher ratings and superior quality of care.

Medicare Savings Programs: Some beneficiaries may qualify for Medicare Savings Programs or Extra Help, offering assistance with Medicare costs. We can check your eligibility and help you enroll in these programs if you qualify.

Now that you have a great medicare plan selected, complete your Senior Care Checklist by making sure you have a long term care strategy. Without long-term care insurance, individuals may have to deplete their savings or sell assets to pay for care. Insurance helps protect these assets, ensuring that they can be preserved for other purposes or passed on to heirs.

Long-term care insurance is crucial for several reasons:

Rising Costs of Long-Term Care: The cost of long-term care services, such as nursing home care, assisted living, and in-home care, is continually rising. Long-term care insurance can help cover these costs, preventing a significant financial burden on individuals and their families.

Comprehensive Care Options: Long-term care insurance policies typically offer a range of care options, including in-home care, adult day care, assisted living, and nursing home care. This flexibility allows individuals to choose the type of care that best suits their needs and preferences.

Medicaid Limitations: Medicaid does provide long-term care coverage, but it requires individuals to meet strict income and asset eligibility criteria. Long-term care insurance provides an alternative for those who do not qualify for Medicaid or prefer not to spend down their assets to become eligible.

Alleviating Family Burden: Without insurance, the responsibility of providing care often falls on family members, which can be physically, emotionally, and financially taxing. Long-term care insurance can cover professional care services, reducing the burden on family caregivers.

Peace of Mind: Having long-term care insurance provides peace of mind, knowing that future care needs will be met without causing financial strain. This can be particularly important for those who want to ensure they receive quality care in their later years.

Increasing Life Expectancy: As people live longer, the likelihood of needing long-term care increases. Insurance helps prepare for this possibility, ensuring that individuals have the resources to cover extended periods of care if needed.

Overall, long-term care insurance is a critical component of financial planning, helping individuals and families manage the potential high costs of long-term care and maintain their financial well-being.
If you have any questions or need assistance, we are here to help. My team looks forward to working with you, and remember, our services come at no cost. We are also happy to simply review your current policy and review your coverage with you.

Carol Foley, Licensed Insurance Agent and Medicare Specialist
Main Line Benefits Co.
1985 South Ocean Drive, Hallandale Beach
610-639-5616
www.mlbenefitsco.com

Senior Checklist:
____ Medicare Planning Complete – Dr in network, medications covered, fits the budget
____ Affordable Long Term Care, Recovery Care, Home Care
____ Final Expense