Hello,
The annual October newsletter with changes to your plan for 2025 has been mailed. You should receive it by October 15, 2024. It is company specific so the letter sent to you is applicable to the company’s plan you have. If you did not receive the letter, please contact Cathy at 330-298-5969. She will send you the appropriate letter. The information below is generic to all the letters that were sent out.
As a reminder we represent all the major insurance companies for Medicare including Anthem, Aetna, United Healthcare, Medical Mutual, Summa, Humana, and Devoted. So, if you get a call from someone telling you about a company plan with some great benefit – Don’t Fall for IT. They are not telling you the whole story. Call us before you do anything and whatever you do, do not give them your date of birth or Medicare number. They need that to switch you from your current plan, not to tell you about another plan.
For those who take prescriptions Your total maximum out-of-pocket expenses for prescriptions for next year will be $2,000. It is a good idea to check with your insurance company to see what your prescriptions will cost next year if you are on prescriptions that you currently have a copay for. Your copays may be a lot higher at the beginning of 2025 than they were in 2024 as some companies have gone to a deductible for Tiers 3-5 and/or a percentage copay rather than a flat dollar amount.
You can use Good RX or other discount prescription cards if they are cheaper than your plan, but remember your copay will not be included in the $2,000 maximum out of pocket. You must use your plan’s insurance card to have the money you pay go to the maximum out of pocket limit.
If your prescription copays are more than you can afford at the beginning of the year, Medicare has a payment plan called Medicare Prescription Payment Plan (or M3P). It is designed to smooth your costs over the year, but it does not save you money. Most companies will notify you if you are likely to benefit from this program. It is new and complicated so I do not recommend it unless you are at a point you cannot pay for your needed drugs early in the year.
Extra Help Reminder: If you have lower income and little savings, you may be able to get extra help on your prescriptions. You can apply at Jobs and Family Services or go online to Medicare.gov/ExtraHelp. For 2024 the income and savings limits for a single person are $1,903 per month with $17,220 savings and for a couple $2,575 with $34,360 savings. We will have the 2025 numbers for you in our winter newsletter. You can also look at Pharmaceutical Assistance Programs for help with the very expensive drugs at go.medicare.gov/pap for more information.
Just an FYI: There are plans out there that offer $100 – $170 a month back in your Social Security check. These plans are ideal for someone who rarely goes to the doctor or uses the VA because the other benefits are not as comprehensive and copays are much higher. There are other plans that offer $150 – $270 in groceries and OTC every month. These plans are only for people on both Medicare AND Medicaid. Some plans offer a $0 copay for specialists or for x-rays BUT they have higher copays elsewhere. My point is Cathy and I are familiar with most all of these plans and benefits so if you hear of something you may want, please call us. Do not get something over the phone because I promise you won’t get the customer service Cathy and I strive to give you and you will find you will be missing benefits that you have now or, you will have much higher copayments somewhere else.
Cathy and I are doing very well. My business is keeping me very busy and Cathy splits her time between the business, family farm, and babysitting grandkids. So, she’s even busier than I am. The grandkids are growing fast and are so much fun. We took the boys fishing in our pond and they were catching fish faster than I could take them off the hook and rebait their hook for them. Baby Micaiah is a lot of fun now too. She’s crawling all over the place and pulling herself up and will be walking pretty soon. The exciting news is our other son Andrew and his wife Allie are expecting their first baby in March. So, the Boring household is growing and is anything but boring.
Cathy and I are here if you have questions. If you think you may want to change plans but aren’t sure, remember we have the open enrollment period next year, January through March, where we can make a change if you need to. Also remember Cathy and I represent all the major Medicare companies in Ohio so there aren’t any plans or benefits out there that we haven’t heard of. If you hear of something that sounds too good to be true or want to know how you can get some “new” benefit, call us and we can tell you all about it.
If you have sent people our way over the last year or two – thank you so much. Please remember referrals are the backbone of our business so if you know anybody on Medicare or starting Medicare, we’d really appreciate your referral. Thank you for the trust that you have in us as your agents. Be sure to let us know if you start MEDICAID or have a change in MEDICAID/Extra Help status as you then have other plan options. Also be sure to let us know if you have an address change because the insurance companies do not give us that information. If you move to a different county, we need to make sure your current plan is available in that county and/or let you know of other plans available to you. Also, we cannot send you any more newsletters. 😊
We hope you have a great Thanksgiving and Christmas.
Take care!
Chris and Cathy