To Liz, please:You have already talked about the benefits and drawbacks of Medicare Advantage programs as comparison to original Medicare. The high cost of Part D prescription drug coverage for those who opt for original Medicare is something else I believe you should bring to the attention of readers.
For instance, you may easily spend $3,000 or more annually if you just require a few pricey medications that are Tier 3 or higher, in addition to the monthly premium.
I don’t mean to be critical of original Medicare. Conversely, it offers you a tremendous deal of autonomy over your health. Part D is pricey, though.
Answer: Let’s begin with the announcement that the maximum out-of-pocket amount for Medicare Part D will be $2,000 in 2025. Both Medicare Advantage plans with prescription medication coverage and Part D plans purchased by individuals on original Medicare are subject to the cap. You won’t have to pay more for covered medications for the remainder of the year after you reach the limit.
Take note of the words “covered drugs.” Private insurers offer prescription drug coverage, and each year, their lists of approved prescriptions may vary. Every year during Medicare’s open enrollment period, which ends on December 7, you should shop to make sure your plan has the coverage you require because an insurance plan that covers a drug this year might not cover it the following year. You may end up spending significantly more than you anticipated if you don’t compare rates during the annual open enrollment period.
As backdrop, commercial insurers provide Medicare Advantage plans as a substitute for traditional Medicare. Medicare Advantage has provider networks and might not cover care outside of those networks, or it might cost more. In contrast, original Medicare lets you choose any doctor who takes Medicare, and the great majority do. Additionally, Medicare Advantage benefits and networks are subject to change annually.
Thankfully, Medicare provides a comparison tool to assist you in evaluating your alternatives. You can choose the best plan for your situation by entering the medications you take and your favorite pharmacy. It’s time to compare and, if needed, change plans.
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Liz Weston, a Certified Financial Planner, writes a column for NerdWallet about personal finance.She can be contacted by phone at 3940 Laurel Canyon, No. 238, Studio City, CA 91604, or via the atasklizweston.com contact form.
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