It is crucial to understand the Inflation Reduction Act and the potential Part D changes that will impact both you and your clients this upcoming Annual Enrollment Period (AEP).
Rest assured, PSM Brokerage is here to provide you with a wealth of resources aimed at helping you understand these changes and stay ahead of the curve.
Overview
The Inflation Reduction Act introduces several key provisions aimed at reducing healthcare costs for Medicare beneficiaries. Key changes include:
- Elimination of the Part D coverage gap: Ensuring continuous prescription drug coverage throughout the year starting in 2025.
- Capping annual out-of-pocket drug costs: Setting a limit of $2,000 on out-of-pocket expenses for prescription drugs, providing significant financial relief.
- Lowering insulin costs: Capping the cost of insulin at $35 per month for Medicare beneficiaries.
- Expanding access to Extra Help subsidies: Increasing eligibility for low-income beneficiaries to receive assistance with Part D premiums, deductibles, and cost-sharing.
- Phasing out 5% coinsurance for catastrophic coverage: Shifting more responsibility to Part D plan providers to cover these costs, which impacts premium calculations.
These provisions are designed to make prescription drugs more affordable and improve overall healthcare access for seniors and people with disabilities.
The Inflation Reduction Act is expected to increase Part D premiums in 2024 due to the elimination of the 5% coinsurance for catastrophic coverage and the added responsibility for plan providers to cover higher costs. However, starting in 2025, the act will cap annual out-of-pocket drug expenses at $2,000, potentially stabilizing costs for beneficiaries in the long term.
CMS Links
- Inflation Reduction Act and Medicare
- Medicare Prescription Payment Plan
- CMS Releases 2025 Medicare Part D Bid Information and Announces Premium Stabilization Demonstration
- Prescription Payment Plan Fact Sheet
- Prescription Payment Plan Timeline
- CMS Part D Redesign Program Instructions
- CMS Part D Redesign Fact Sheet
Inflation Reduction Act Articles
- New Medicare Guidance on Lowering Prescription Drug Costs
- Upcoming Changes and Strategic Planning for AEP
- Educating Clients on the Inflation Reduction Act’s Medicare Reforms
- Understanding the Inflation Reduction Act's Impact on Medicare
- CMS Releases 2025 Medicare Part D Bid Information and Announces Premium Stabilization Demonstration
- Forbes Article
Client Marketing Outreach
In preparation for these changes, we have developed some helpful resources you can use to engage your clients and take a pro-active approach. In addition, this blog article will walk through some important steps and timelines to prepare for so you have a strategic plan in place.
By following this plan, you can efficiently manage the AEP period, keep clients informed, and ensure they are enrolled in the best possible plans for their needs.
If you need assistance, please call us at (800) 998-7715 and ask to speak to a marketing representative. You can also email us at info@psmbrokerage.com
Additional Resources
For insurance agents, the changes brought by the Inflation Reduction Act (IRA) mean you must be proactive and well-informed to assist your clients.
The increase in Part D premiums in 2024 will require you to help clients understand and manage these higher costs. Additionally, the cap on annual out-of-pocket expenses starting in 2025 presents an opportunity for you to emphasize the long-term benefits of these changes, ensuring clients are aware of potential savings and improved financial stability.
You will need to stay updated on these developments and adjust your strategies accordingly to provide the best possible guidance and support during the Annual Enrollment Period (AEP) and beyond.