About All Those Annoying Medicare Ads;
A Prescription Drug Game-Changer; Gratefulness, and more…
Ever Wonder About the Effectiveness of All Those Ads That Besiege Us During the Annual Enrollment Period?
I don’t know about you, but my mailbox at home certainly was chock full of Medicare mailers almost daily in September, October, and November. Then there’s the flood of ads on TV, radio, social media, etc. The onslaught that besieges us for three months solid every year is all pretty doggone relentless. Now consider this…….
Healthcare research foundations like The Commonwealth Fund and The Kaiser Family Foundation report that fewer than 10% of all Medicare Advantage enrollees actually end up changing plans. Fewer than 2 percent of Medicare Advantage plan enrollees switch to Traditional Medicare.
……It really makes me wonder about the logic and justification of all the money, time, and other resources spent each fall (Annual Enrollment Period) on the huge volume and incessant nature of these annual ad campaigns — whether it’s print, TV, radio, social media, you name it – that we’re subject to endure each year……
In an upcoming post, I’ll be sharing why it’s usually prudent to just stick with a plan that’s working for you, why I caution against getting sucked in by all the embellishments and misleading promises of greener grass, some thoughts on the implications of changing plans; and instances when it actually may be time to consider changing plans…..
This Medicare Prescription Drug Game-Changer Takes Effect in 2025.
Beginning in 2025, Medicare enrollees will pay no more than $2,000 in out-of-pocket costs for covered prescription drugs. This should be a big relief, especially for those on the most expensive medications.
If you want to learn more, here’s a recent brief from Kaiser Health News: Millions of People with Medicare Will Benefit from the New Out-of-Pocket Drug Spending Cap Over Time.
In an upcoming post, I’ll be sharing why it’s usually prudent to just stick with a plan that’s working for you, why I caution against getting sucked in by all the embellishments and misleading promises of greener grass, some thoughts on the implications of changing plans; and instances when it actually may be time to consider changing plans…..
“Not so fast my friend” (Coach Lee Corso, ESPN’s College Game Day), Medicare, and the New Weight Loss Drugs.
I never could have imagined I’d be including this signature football phrase in the same sentence with the New Weight Loss Drugs and Medicare. However, in this case, the shoe does seem to fit. Here’s why………
An issue related to the expensive new weight loss drugs continues to pop up in a broad spectrum of conversations, so I thought this is worth sharing……. Even though popular new weight-loss drugs like Mounjaro (tirzepatide) and Ozempic (semaglutide) may appear on your Medicare plan’s formulary (drug list), Medicare rules still specifically exclude coverage of these medications for strictly weight-loss purposes. Before covering Mounjaro, Ozempic, and others, Medicare Prescription Drug plans require that an appropriate diagnosis that supports Medicare’s medically accepted indications for use, such as for Type 2 diabetes, be designated on the prescription from the provider.
To avoid frustration at the pharmacy and receive the medication when needed, make sure your provider includes an appropriate diagnosis code for Type 2 diabetes with the script. If the plan and/or pharmacy is unable to validate a proper diagnosis, you may find coverage for the script is denied.
All Medicare Prescription Drug Plans are required to adhere to these Medicare coverage rules.
Public Service Announcement: Don’t Miss Relevant Medicare Coverage Information.
Not receiving important information can be costly. To avoid the consequences and frustration of missing important notifications regarding benefits, costs, coverage, claims, reimbursements, etc., take the time to make sure your information is up to date with entities like Medicare and your respective Medicare Advantage/Medicare Supplement/Prescription Drug plans. Whether it’s a mailing address, last name, email address, or some other piece of demographic information that has changed, be sure to notify the following entities to ensure your information is correctly updated in their systems:
1. Social Security Administration (Medicare works with SSA to maintain your records, so you have to contact SSA to update your information. If you only have Medicare and don’t receive Social Security benefits yet, you still contact SSA to update your address with Medicare.)
2. Medicare Advantage/Medicare Supplement/Prescription Drug Plans – Call the number on the back of your member ID card.
Now is a good time of year to do this.
If there are specific topics you’d like us to address in future issues please drop us a line at 65plus@bbginc.net with your suggestions.