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Medicare Advantage Plans annual enrollment is now open!
It's that time of year again—Medicare’s annual enrollment period opened on November 1 and runs through January 15, 2025.
Each year, changes to Medicare Advantage plans make it essential for members—whether residents, patients, friends, or relatives—to review options carefully and ensure they have a plan that best suits their specific healthcare needs.
This year, the program's changes are the largest in a decade, making careful consideration especially important during this open enrollment period, as plans may need to be updated.
At Red Rock Pharmacy, we often work with patients’ prescription drug plans, which are provided either by Medicare Part D (covering medications for beneficiaries with traditional Medicare Parts A and B, now accounting for around 50% of beneficiaries) or through a Medicare Advantage plan’s prescription benefits. Medicare Advantage plans have grown rapidly in recent years and now cover almost 50% of all beneficiaries.
So, how should beneficiaries decide on a plan?
With original Medicare, beneficiaries will need to enroll in a Part D (prescription drug) plan as part of their overall Medicare benefit. While there are several different Medicare Part D plans available, the best way to choose one under original Medicare is by visiting medicare.gov/plan-compare.
By answering a few questions about the beneficiary's location and medications, the plan finder will show the estimated monthly out-of-pocket costs for plans in their area. This year, Medicare Part D includes an option to pay the total drug bill in monthly installments over the year, with a maximum out-of-pocket cost of $2,000 in 2025.
For Medicare Advantage plans, the process is more complex:
Medicare Advantage plans are offered by private insurers rather than the federal government, so beneficiaries will need to check specific insurer websites for coverage details. Key elements to look for include:
- Formulary (list of covered drugs)
- Full list of covered drugs
Drug coverage varies between insurers, and not all Medicare Advantage plans include prescription coverage. In cases where prescription coverage isn’t included, a stand-alone Part D plan, as outlined on the Medicare website, may be purchased (Dave, could you supply a link, please?). For 2025, out-of-pocket medication costs for Advantage plans are also capped at $2,000.
Feeling confused? You’re not alone! You can find more easy-to-understand information HERE.
David Rimlinger
Director of Marketing
Editor’s Note: Dave has done a great job summarizing a complex issue. Here at Red Rock Pharmacy, we will strive to keep you updated. Since the above was written, more examples of the upcoming changes have been published.
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