This is behind-the-scenes information, not reported by any news outlet…yet.

I had dinner last month with a friend in our business. He is actually a big deal in one of the largest insurance companies in the Medicare space. I tried to enjoy my meal after he shared some coming changes to Medicare plans in 2023 and 2024.

He mentioned briefly that MEDICARE has changed a rule affecting every Medicare beneficiary. We have all seen the latest “Landmark Bill to Cut Prescription Drug Prices,” the one slated to cap prescription drug costs at $2,000 per year… that one.

This is great for folks with medications, severely cutting into their monthly budget. But what about the majority of Medicare beneficiaries that only take generic maintenance medications, pay low or no copays, have no deductibles on their plans for those medications, and their plan premium is less than $20/month? What about those folks?

I was so flabbergasted at what he shared. Then, heartbroken for our clients. So, here it is.

“Medicare will no longer allow insurance companies who offer Part D prescription plans and Medicare Advantage plans (which include Part D prescription benefits) to pass through their savings from drug manufacturers to Medicare beneficiaries beginning in 2023.”

What does that mean for the 50-plus million folks reliant on Medicare for prescription drugs? Again, we will see when the plans are released in October, and we will begin our research. My guess is Higher costs!

Higher costs in multiple ways. For folks with Medicare Advantage plans, in the past, most plans did not have a deductible for any prescriptions. For folks on Medicare supplements, the inexpensive Part D plans will go away or back to the old prices averaging about $30 per month. That is potentially triple the current premium for many people in 2022. But, again, my comments are a guess. We will see what the plans look like in October.

The other effects could just be higher copays for maintenance drugs. Some drugs could move up a tier. For example, some generics are actually on the preferred brand tier this year. So I guess we could see more of that. (In English, less $0 copay medications.) These changes could also be phased in 2023 and 2024.

I am mad. I feel that the elected folks are lying. First, they say they want to reduce the cost of prescriptions for Medicare beneficiaries; that’s a good thing! Then they change a rule that may negatively impact them later down the road.

This makes what we do for our clients even more vital.

It is absolutely critical that everyone has a Certified Medicare Planner® to help them with their plan research. Initially, when just turning 65 and going on Medicare, and again annually to ensure their plan continues to be suitable for them. Experts will look at every plan available, not just the plans that will pay a commission.

Stay tuned to the newsletter for more critical information as we approach the Medicare Annual Election Period.