Maximizing Your Medicare and Part D Coverage: A Mid-Year Enrollment Review

Introduction

As we reach the midpoint of the year, it's the perfect time to review your Medicare and Part D coverage. With recent changes to Medicare and evolving options for CT Medicare Advantage plans, a mid-year checkup ensures you're getting the most value from your health coverage and are prepared for the upcoming open enrollment period.

• Stay Current with Plan Changes: Medicare plans, including Part D and Medicare Advantage, often update their benefits, premiums, and formularies each year.
• Prepare for Open Enrollment: The annual Medicare open enrollment period runs from October 15 to December 7, allowing you to switch plans or make adjustments.
• Maximize Savings: Recent reforms, such as those from the Inflation Reduction Act, are lowering out-of-pocket costs for prescription drugs in 2025.

1. Fewer Stand-Alone Part D Plans, More Advantage Options

• In 2025, the average beneficiary can choose from 48 Medicare plans with Part D drug coverage, including 14 stand-alone prescription drug plans (PDPs) and 34 Medicare Advantage drug plans.
• The number of firms offering stand-alone PDPs has dropped, while CT Medicare Advantage plans with drug coverage remain robust.

2. Lower Out-of-Pocket Prescription Costs

• The Inflation Reduction Act is projected to save Medicare beneficiaries an average of 30% in annual out-of-pocket prescription drug costs in 2025.
• The catastrophic coverage phase coinsurance has been eliminated, and a new $2,000 out-of-pocket cap for Part D will take effect in 2025, down from $3,300–$3,800 in 2024.

3. Enhanced Benefits and Subsidies

• Expanded eligibility for the federal Extra Help program.
• No cost-sharing for vaccines and a monthly insulin copay cap.

Review Your Current Plan

• Check if your medications are still covered and if your preferred providers are in-network.
• Compare your current plan's premiums, deductibles, and out-of-pocket maximums with other available options.

Explore CT Medicare Advantage Plans

• CT Medicare Advantage plans often include additional benefits such as dental, vision, and hearing coverage, along with prescription drug coverage.
• Evaluate if switching from Original Medicare to a Medicare Advantage plan could offer better value or coverage for your needs.

Prepare for Open Enrollment

• Mark your calendar for October 15–December 7 to make any necessary changes.
• Gather updated information on your health needs and prescription drugs to compare plans effectively.

Q: Can I switch from Original Medicare to a Medicare Advantage plan mid-year?

A: Generally, you must wait for the annual open enrollment period unless you qualify for a Special Enrollment Period due to certain life events.

Q: What if my prescription drug costs are very high?

A: The new $2,000 cap on Part D out-of-pocket costs in 2025 will provide significant relief for those with high prescription expenses.

Navigating CT Medicare Advantage plans and Part D options can be complex, especially with ongoing changes. CT Insurance Agency is here to help you review your coverage, compare plans, and ensure you're maximizing your Medicare benefits for 2025 and beyond.

Contact CT Insurance Agency today for your personalized Medicare review and make the most of your coverage this year.