WHY WILL THIS AEP BE DIFFERENT?
As you have probably heard, there are big changes to 2025 drug plans as carriers adjust to their increased responsibility due to the 2023 Inflation Reduction Act. As a result, some people will be relieved to have an annual cap on their out-of-pocket costs and others will be unhappy to see their premiums, deductibles and generic medications cost more.
Another big change is the new Medicare Prescription Payment Plan. Enrollees will now have the option to pay out-of-pocket costs in the form of capped monthly payments instead of all at once at the pharmacy for qualifying prescriptions. This will make meeting the deductible less painful. While you will need to opt-in to this program, pharmacies are required to offer this to you if your prescription qualifies.
All insulin will continue to be capped at $35/month and prices for 10 high-cost brand named drugs are now being negotiated for price reductions starting in 2026.
Because of the many changes and uncertainty for our clients, we are expecting to see a higher volume of reviews and recommendations this year. We want to make sure our clients are informed about the changes and the choices they have. In addition to our monthly newsletters, we will reach out to our clients in specific Part D and Medicare Advantage plans with information about their plan changes for 2025 via email. Due to the expected volume, we will also provide plan specific webinars and will go over the changes on those plans where we have many clients.
And as a reminder, the Annual Enrollment Period (AEP) for Medicare begins on October 15 and runs through December 7th. This is the only time that people who have a Part D drug plan can make a change for next year. It is also the time for those in a Medicare Advantage plan to change to a different plan or back to original Medicare with a supplement and Part D.
It is not necessary to make changes to your Medicare Supplement plan at this time as there is an ongoing enrollment period for supplement plans.
WE VALUE YOUR BUSINESS
Kindly we ask that you please be patient with us this year. In a normal AEP we may make changes for 250 to 300 of our clients on a drug or Advantage plan. This year we expect 2 – 3 times more plan changes in the 8 weeks of AEP. We are trying to be as efficient as possible so we can take care of everyone who needs our help.
This means automating some of our processes and doing more webinars and group meetings to accommodate more people in the same number of hours that we have for every AEP.
HOW WE WILL APPROACH THIS AEP
We will be sending forms to automate the compliance regulations this year. Everyone who has a Medicare plan with us will receive the Scope of Appointment form beginning in late September via email or text, and it must be completed 48 hours in advance of any meeting. Most of you have done this before, but if you have any questions or problems reach out to us for technical assistance.
Next, we will send a request for an updated prescription drug list. Those who anticipate a change or want a review must send the information and the Scope of Appointment back prior to receiving a review.
Once we have everything in hand, Karen and Matt will review your information and we will send out your PDP or MAPD review with a link to our quoting software, Plan Compare Edge, containing your current medications and plan. If a change is appropriate, we'll provide you with one or two recommendations. Additionally, you'll have the opportunity to:
Attend a webinar where I will give a full presentation for each of the common products that we represent, and you will be able to ask questions about the plans. These will start after October 15th .
Self-enroll from the review link or ask for technical help enrolling from Matt if you are comfortable with the recommendation and ready to enroll.
Schedule a meeting if you have a complex situation with a drug or Advantage plan and need an individual appointment to discuss it. We will begin scheduling those meetings after October 1st.
Schedule a meeting for simple PDP changes only, which will be in limited time blocks. We will send out a schedule of those meeting times for you to choose.
THE UNINTENDED CONSEQUENCES
Unfortunately, some Part D carriers have discontinued commissions (how we get paid) to brokers as a cost-cutting measure. As we have always done in the past, we will continue to recommend the best plan for each of our clients, regardless of whether there is a commission paid for our advice or not. We know that you have other business with us that does pay a commission and appreciate all the referrals you give that help us stay in business.
If you have any additional questions, contact our team today!
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