If you have a Medicare Advantage or Medicare Prescription Drug plan - the benefit details change each year.
Let’s talk about Prescription plans, also called
Medicare Part D, PDP, or Rx drug plans.
These plans help consumers with the cost of prescription medicines. Medicare approves a wide variety of prescriptions for each type of illness. The insurance companies use this list to decide what medications they will cover.
Medicare sets the framework on how plans cover these medications. For plan year 2024, the insurance companies may charge a deductible of no more than $545.
Then the initial benefit amount is $5,030. Important – this is the combined amount of what YOU pay for medications and what price the insurance has bought these medications from the manufacturers. If your Rx use is over this amount – then there is another level of cost sharing where you will pay only 25% of the cost of brand name medications and 15% of generics.
Finally if your "True Out of Pocket Costs" (this is the total of your deductible, your copays in the initial benefit stage and all the costs in the "gap") is capped $8,000 - Then the insurance plan pays 100% of the cost. Doing the math from above, your actual out of pocket costs in total should be around $3,400
Big Changes to Medicare Part D Insulin Coverage in 2024
For 2024, Major changes are coming to insulin coverage through Medicare Part D. Insulin is a vital medication for millions of Americans, and the high costs associated has prevented some enrollees from receiving their necessary prescription each month. In January, Medicare Prescription Drug plans are no longer able to apply the Medicare Part D deductible to any insulin product listed on a plan’s formulary or any vaccine recommended by the Advisory Committee on Immunization Practices.
Also, a Medicare Part D plan may not charge more than $35 for a month’s supply of insulin in the initial coverage phase or coverage gap phase. This cost decrease is a big benefit for those who previously were unable to afford their prescription and makes receiving life-saving medication accessible for a wider range of Medicare enrollees.
Also, a Medicare Part D plan may not charge more than $35 for a month’s supply of insulin in the initial coverage phase or coverage gap phase. This cost decrease is a big benefit for those who previously were unable to afford their prescription and makes receiving life-saving medication accessible for a wider range of Medicare enrollees.
The "ANOC" Letter
During September and early October – your current insurance plan will be sending you details about next years plan.
Annual Notice of Change! – We call this the A-NOC letter. It will detail the Rx tiers, its formulary and the premium for 2024. Overall- if your medications have NOT changed in the last year, your current plan may still be the best value. Especially if you take only a few low cost genetics or no medications at all. |
But if you do take several meds - especially brand name - or your prescriptions have changed during this last year, we do need to review your options for this next year.
Please look for an email with instructions to connect your Medicare.gov account to our new secure software “Medicare Center".
Please look for an email with instructions to connect your Medicare.gov account to our new secure software “Medicare Center".
This will allow us to see your actual prescriptions filled through your current plan and then compare ALL the plans available for 2024.
If you prefer - call our office or email your current list of medications. Or go to our page Enroll for 2024 and enter your medications here.
However is most convenient for you - this will give us the information we need to help find you the most effective coverage for 2024.
However is most convenient for you - this will give us the information we need to help find you the most effective coverage for 2024.
Many Thanks, and we appreciate the opportunity to serve you.
Dave Trout
Jessica Cody
Jeremy Sheridan
David Hanson
Idelle Davids
Dave Trout
Jessica Cody
Jeremy Sheridan
David Hanson
Idelle Davids