Many villagers are unaware of the new law that includes Medicare benefits

According to Jim Bodenner, president of the Villages chapter of the National Retiree Legislative Network (NRLN), many residents of The Villages are unaware that a new law includes Medicare and other health care benefits.

The NRLN Villages Chapter was established in September 2016. The NRLN is based in Washington, DC and is a national, nonpartisan, nonprofit organization dedicated to representing the interests of retirees and future retirees.

Bodenner said he was recently invited by a law firm in The Villages to talk to their clients about Medicare and other health insurance coverage. “There were people in the audience who were surprised to learn from me that starting in 2023, Medicare will cap the cost of insulin at $35 per month. Everyone was thrilled to learn that starting in 2025, the amount of out-of-pocket expenses Medicare Part D beneficiaries will have to pay annually for their prescriptions will be capped at $2,000.

He said the U.S. Senate and House cut short their usual month-long hiatus in August to pass legislation providing improvements to Medicare and other health care benefits. The Senate passed the bill on August 7 and the House passed it on August 12. President Biden signed the law into law during a ceremony at the White House on August 16.

Bodenner noted the additional benefits provided by law as well as $35 per month for insulin and the $2,000 annual cap for prescription drugs:

  • As of January 1, 2023, people enrolled in Medicare will have no out-of-pocket costs for vaccines recommended by the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices for adults.
  • In 2024, the year before the out-of-pocket cap takes effect, Medicare beneficiaries will no longer have any out-of-pocket payments if they reach Medicare catastrophic coverage. The way catastrophic coverage works in 2022 is that once an enrollee’s out-of-pocket expenses reach $7,050, they pay 5% of their prescription drug costs, with no limit. In 2024, the 5% coinsurance requirement will be gone and enrollees will not have to pay anything for their prescription drugs for the rest of the year. Also from 2024 until 2029, Part D premiums cannot increase by more than 6% per year.
  • Starting in 2025, Medicare Part D plans will offer the “smoothed cost sharing” option. This means that Part D participants can choose to spread their disbursements over the year. This is designed to avoid being hit with a large drug bill at some point, which could discourage filling prescriptions.
  • In 2026, Medicare will begin to negotiate drug prices.

“Although the NRLN would have preferred legislation to require Medicare to use the (commercial) bidding model it proposed to members of Congress, it is historic that the new law will allow Medicare to eventually negotiate the price of some expensive prescription drugs. “, Bodenner said. “However, the NRLN and the Villages Chapter will continue to press for more drugs to be included in price negotiations.

Bodenner said he was available to speak to clubs in The Villages about Medicare. His email address [email protected]

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