The Medicare ads are coming.
Open enrollment begins October 15, and your mailbox, TV, and social media feed will soon be flooded.
But understanding Medicare is anything but easy.
Here’s a quick guide to help you cut through the noise:
✅ Step 1: Review Your Annual Notice of Change
If you have Part D prescription drug coverage, your plan must send you an update by the end of September. It outlines any changes to:
- Premiums and deductibles
- Drug coverage (called the formulary)
- Copays and out-of-pocket limits
Action: Make sure your current medications are still covered, and see if your total costs (not just premiums) will rise.
✅ Step 2: Compare All Part D Options
Use the official Medicare Plan Finder to explore available plans in your area.
Things to look for:
- Are all your prescriptions still on the formulary?
- What’s your total expected cost (premium + copays)?
- Are your preferred pharmacies included in the network?
- Do your meds require prior authorization or step therapy?
✅ Step 3: If You Have Medicare Advantage (Part C), Review These Too
Medicare Advantage combines Parts A, B, and usually D into one plan, but not all plans are the same.
Check for:
- Monthly premiums + out-of-pocket max for care
- Prescription drug costs
- Your doctors and facilities. Are they in-network?
- Charges for out-of-network care
- Star ratings (based on quality and customer satisfaction)
- Added benefits like dental, vision, and hearing
In 2024, the out-of-pocket max for Medicare Advantage is capped at:
- $8,850 (in-network)
- $13,300 (combined in/out-of-network)
Some plans offer lower limits, so it’s worth comparing.
✅ Bonus: Watch for Special Programs
Some plans include extra support for chronic conditions, and changes in law have capped prescription costs at $2,000 annually, but only for drugs on your plan’s formulary.
Choosing the wrong Medicare plan could cost you thousands.
Make this the year you get it right.
Need help comparing plans or understanding what all this means?
Give me a call.
