Here’s what you need to know about the changes coming to Medicare prescription drug coverage

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By Donna Zachary, Zachary & Associates of Ohio

If you or someone you know uses Medicare for health insurance, there are some important changes coming in 2025 that will make it easier to pay for medicines. The Inflation Reduction Act (IRA) has made waves in policy circles, not just for its broad economic implications but also for its targeted measures aimed at alleviating the burden of prescription drug costs for Medicare beneficiaries. This landmark legislation is poised to transform the landscape of healthcare affordability in the United States, providing significant relief to millions of seniors who have long struggled with the high costs of medications. To maximize these benefits, beneficiaries should consider speaking with a local Medicare agent for a thorough drug review. Here’s what you need to know in simple terms.

Spending Limit
Starting in 2025, there will be a limit on how much money you can spend on medicines each year. You won’t have to pay more than $2,000 (not including your monthly premiums). This is great news because it means that even if your medicines are very expensive, you won’t have to spend more than this amount in a year. This cap provides significant financial relief, ensuring that no senior will face catastrophic expenses due to necessary medications.

Paying for Medicines Over Time
Instead of paying a lot of money all at once when you go to pick up your prescriptions, you can spread out the cost of your medicines over the calendar year. This option will be most beneficial to those who are on high-cost medications. You will have to enroll in the Medicare Prescriptions Payment Plan program this coming fall or at any time after January 1.

Cheaper Insulin
If you or someone you know uses insulin, there’s good news. Insulin will cost no more than $35 a month. This is really helpful because insulin is very important for people with diabetes, and it can be expensive.

Help for Low-Income People
If you don’t have a lot of money, there will be more help to pay for your medicines. The IRA expands eligibility for low-income subsidies under Medicare Part D. This change will allow more beneficiaries to receive additional financial assistance, helping to cover premiums, deductibles and copayments. Medicare will lower costs for people who qualify through a program called Extra Help, so you won’t have to worry as much about paying for your medicines.

Zero-Cost Vaccines
Vaccines are shots that help protect you from getting sick. Some important vaccines, like shingles and pneumonia, will be available at no charge for people with Medicare.

When These Changes Happen
These changes will start in 2025. To fully benefit from these changes, Medicare beneficiaries are encouraged to speak with a local Medicare agent, like me, for a comprehensive drug review to help them understand how these changes will impact them and help them get the most out of their benefits. The best part is that there is no charge for my help.

As a licensed Medicare broker with Zachary & Associates, Donna Zachary has more than 30 years’ experience specializing in the senior market, providing Medicare supplements, Medicare advantage Part C, Part D, hospital indemnity, dental, vision, cancer, life and travel insurance. Donna strives to provide each client with the right coverage, at the right price, for the right reason. For more information, call Donna Zachary at 216-410-1034 or visit DonnaZachary.com.

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