Jess and Sandra Carrasquillo, owners of Easy Street Insurance in Greenwood, have been trusted advisors to thousands of seniors across central Indiana for over 25 years. As independent Medicare brokers, they represent top-rated insurance carriers and are dedicated to helping seniors navigate the complex world of Medicare. With the Medicare sign-up period for 2025 just around the corner, Jess and Sandra discuss the significant changes happening this year and how they are preparing to guide their clients through these major changes. In 2024 there were over 60 million Americans on Medicare. That number will likely grow to over 70 million in 2025 according to Centers for Medicare & Medicaid Services.
Understanding the Key Changes in Medicare for 2025
“2025 is going to be a disruptive year for Medicare,” Jess says. “The most significant changes are due to the Inflation Reduction Act. This affects stand-alone drug plans and Advantage Plans. Since the inception of Medicare Part D in 2006, the prescription drug plans have had four phases: the Deductible phase, Initial Coverage phase, the Coverage Gap (doughnut hole) and finally the Catastrophic phase. So, what is changing? In 2025 there will only be three phases. The Coverage Gap will be eliminated. No plan member will spend more than $2,000 annually out of their pocket for medications. These adjustments could lead to changes in premiums, copays, and medications could change tiers (pricing levels). Some medications may be removed from formularies (the company’s covered drug list). In turn, beneficiaries will need to review and possibly switch their plans due to these updates.”
“This change means that prescription drug plans will bear much more of the drug costs in the Catastrophic phase,” Sandra adds. “Before, Medicare reimbursed a larger percentage, but next year that reimbursement drops to just 20%. We’re also seeing a reduction in the number of Part D plans available. Some plans may even drop out of the market in your area.”
Jess and Sandra emphasize the importance of seniors reviewing their Annual Notice of Change (ANOC), which will be sent out at the end of September. “This year about 90% of Medicare beneficiaries are expected to receive a negative ANOC,” says Jess. “That means it’s crucial for everyone to read their notice and understand the changes to their current plan.”
“This isn’t a year for seniors to assume that keeping their existing plan is the best choice,” Sandra says. “With so many changes, especially in prescription drug coverage, every senior needs to review their options.”
How Easy Street Insurance Is Preparing
In response to these major changes, Easy Street Insurance has started preparing much earlier than usual. “We began reaching out to our clients in July, two months earlier than we typically do,” Jess explains. “We’re using a mix of emails, texts, voicemails and other automation tools to ensure we’re communicating effectively. We’re gathering detailed information from our clients, like their list of medications, doctors and preferred pharmacies, so we can analyze the new plans as soon as Medicare releases the data on October 1.”
Sandra mentions that this proactive approach is necessary due to the significant decrease in plan options. “We don’t know exactly how many prescription drug plans will be available, but it will definitely be fewer, with some companies leaving the market. We want to be ready to provide our clients with the best options available.”
Here are some factors to consider, depending on what type of coverage you have:
Medicare Supplement Plan and Drug Plan
While on a Medicare Supplement plan, such as plan F, G, D or N, the coverage does not change from year to year. If you are happy with your current Supplement, you do NOT have to do anything; your plan will carry over to next year.
Has your Medicare Supplement increased significantly in cost? If so, we can have a discussion about applying for a new Supplement if you can pass health underwriting questions. The other option is to discuss moving to an Advantage plan.
Maybe you’re satisfied with your current Supplement but your stand-alone prescription drug plan has increased significantly – you might want to consider an Advantage plan, which includes drug coverage.
Medicare Advantage Plan
- Are you satisfied with your plan overall?
- Will the maximum out-of-pocket protect you from excessive financial bills?
- Are the medical copays reasonable?
- Has your plan implemented a drug deductible that will adversely affect you?
- Consider the overall coverage, as opposed to placing too much emphasis on extra benefits like dental, vision, OTC, etc.
As we approach the Medicare sign-up period for 2025 (October 15 – December 7), the Easy Street team is working tirelessly to ensure that seniors in central Indiana are well-prepared for the upcoming changes. Easy Street Insurance’s commitment to personalized service and education makes them a valuable resource for anyone navigating the complexities of Medicare.
