By Susan Bianchi

This year will see reduced costs and increased accessibility for many Medicare recipients due to changes in Part D of Medicare’s prescription benefits. Despite the many benefits, Medicare recipients will also need to be prepared for some disadvantages.

Advantages to Medicare Recipients

  • An out-of-pocket cap for $2,000 per year for covered drugs
  • Ability to pay for prescription drugs in monthly installments, instead of all at once
  • Cost sharing for covered insulin will be capped at $35 per month
  • Manufacturer Discount Program will replace the Coverage Gap Discount Program known as the “donut hole,” reducing financial burdens and providing more predictable drug costs
  • Plans will have increased liability for the Part D benefit, but will receive a larger upfront government subsidy
  • Medicare’s liability for catastrophic drug costs will be reduced
  • No out-of-pocket for vaccines recommended by the Advisory Committee on Immunization Practices

Possible Problems for Medicare Recipients

  • Higher premiums
  • Limited drug formularies
  • Changes to pharmacy networks resulting in inconvenient locations and higher copays
  • Need to shop for alternative insurers to meet your needs

Essential Solutions is available to walk you through the winding maze, and help you make the absolute best decision regarding your health care. Contact Ken Sciarrino, Regional Vice President for Essential Solutions Northeast Region, at 716-870-6663 or ken@essentialsolutionsusa.com.