CLEVELAND, Ohio — More than 400 participants signed up to hear expert advice Thursday about changes in Medicare during the free webinar, “Guide to Medicare and Golden Retirement,” presented by the Plain Dealer and cleveland.com.
Here is a video of the 90-minute webinar.
This year’s event covered topics such as 2025 Medicare enrollment options, what to consider when choosing a drug plan, the difference between Medicare and Medicaid, and more.
Audience members asked questions to help determine the Medicare plan that’s right for them.
Speakers included Ohio Senior Health Insurance Information Program Director Christina Reeg, Medical Mutual account manager Amanda McFarland and Medical Mutual director of pharmacy Medicare and information services Katie Goff.
Moderator was Plain Dealer and cleveland.com healthcare reporter Julie Washington.
Goff and McFarland took questions about Medicare Part D and how to avoid common mistakes when choosing a drug plan.
Reed and McFarland answered questions on the best way to choose a plan, such as common out-of-pocket costs that people overlook.
Every year, Medicare health and drug plans can make changes to things like cost, coverage, and what providers and pharmacies are in their networks. The open enrollment period now underway is when all Medicare recipients can change their Medicare health plans and prescription drug coverage for the following year to better meet their needs.
Medicare changes coming in 2025
Here’s what you need to know about the some of the Medicare changes coming in 2025, and how to avoid scams. AARP, the Ohio Health Insurance Assistance Program, the Centers for Medicare and Medicaid Services, the Federal Trade Commission and LifeLock provided information.
Out-of-pocket spending capped at $2,000 for prescriptions
One of the biggest changes takes effect in 2025. Part D drug plans must cap out-of-pocket spending on covered drugs at $2,000 a year. It will benefit enrollees with high drug costs by allowing enrollees to pay their prescription costs monthly rather than all at once.
The $2,000-a-year out-of-pocket limit for prescription medications applies to stand-alone Medicare Part D and drug coverage in Medicare Advantage plans.
The cap includes deductibles, copayments and coinsurance for covered drugs. It doesn’t apply to Part B drugs, such as injections at the doctor’s office.
More ways to get weight loss drugs
Medicare is prohibited from covering drugs prescribed specifically for weight loss.
But Part D plans can cover popular weight loss drugs when they’re prescribed for other purposes, such as Ozempic and Mounjaro being used to treat Type 2 diabetes.
In March, the Food and Drug Administration approved Wegovy for overweight people with cardiovascular disease. Wegovy is likely to be subject to relatively high cost-sharing because of its high price, but Part D enrollees who take it will benefit from the new $2,000 cap on their drug expenses.
Midyear statement from your Medicare Advantage plan
The midyear statement will show available benefits that haven’t been used yet. Those extras are often what persuades a Medicare enrollee to sign up with a particular plan.
More accurate TV ads for Medicare Advantage
You’ll continue to see more realistic TV ads about Medicare Advantage plans, the private insurance alternative to original Medicare. Rules that took effect last year prohibited Medicare Advantage ads from mentioning benefits not available in the area where the ad appears. The ads also can’t mislead you into thinking you’re contacting a government agency when you call with questions.
Expanded program for family caregiver services
A 2024 program for dementia patients and their caregivers will quadruple in 2025, serving more of the country.
The program, called Guiding an Improved Dementia Experience, provides a 24/7 support line, a care navigator to help families find medical services and community-based assistance, caregiver training and up to $2,500 a year for at-home, overnight or adult day care respite services. Patients and their caregivers typically won’t have copayments.
The number of healthcare organizations participating in the dementia program will expand from about 100 to nearly 300.
To see if a program is available in your area, go to the CMS GUIDE program fact sheet and find the link to the CMS Innovation website.
More mental health providers added to Medicare
Even though many telehealth expansions during the COVID-19 pandemic will expire at the end of this year, Medicare permanently expanded access to telemedicine for behavioral health services to increase access to providers.
Julie Washington covers healthcare for cleveland.com. Read previous stories at this link.