Major Medication Coverage Changes Ahead for Medicare Enrollees
In a recent segment of The Financial Guys radio show, hosts Mike Sperazza, Mike Lomas, and Brian Faraci discussed the complexities surrounding Medicare’s upcoming open enrollment season, which officially starts on October 15th. They highlighted that the period is a busy time for their team, with a significant amount of work going into helping clients navigate changes in their healthcare plans.
A central topic of the discussion was the impact of medication changes on enrollees. Faraci noted that shifts in medication coverage are more substantial than initially anticipated. Specifically, many drugs are being reclassified, moving from one tier to another. For instance, a medication previously classified as a tier two drug, with a $10 copay, may be moved to tier three, resulting in a higher copay anywhere from $40 to $70. This change can substantially increase out-of-pocket costs, especially for individuals who require multiple medications throughout the year.
Understanding the Challenges of Annual Notice of Changes
The hosts also addressed how people find out about these changes. Insurance companies send out an “annual notice of changes,” but these documents are often difficult to interpret without a solid understanding of health insurance. The hosts stressed the importance of seeking independent advice to review one’s medication and doctor coverage, providing month-by-month cost breakdowns and options for cost-saving measures such as utilizing coupons from services like GoodRx or SingleCare.
The conversation underscored the need for professional assistance during open enrollment, given the potential financial implications of Medicare plan adjustments and medication coverage changes. You can find all radio replays of the full conversation about the upcoming annual enrollment period here.
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