Important Changes to Medicare Drug Coverage for 2025

The Inflation Reduction Act (IRA) has resulted in significant changes to Part D including: Elimination of the Coverage Gap or “donut hole”A new $2,000 out-of-pocket spending capA shift in cost sharing responsibility in the catastrophic coverage phaseA new cost sharing smoothing option called the Medicare Prescription Payment Plan These changes have an enormous impact on your Medicare coverage in 2025 for nearly all those on Medicare including Medicare beneficiaries who are still choosing their employer plans. Please review your ANOC carefully for your 2025 coverage and contact your Total Benefit Solutions Inc health insurance experts if you have any questions or concerns about how these changes impact you and your… Read More

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CMS Releases 2025 Medicare Part D Bid Information and Announces Premium Stabilization Demonstration

The Centers for Medicare & Medicaid Services (CMS) is releasing preliminary technical Medicare Part D bid information for contract year 2025 to help Part D plan sponsors finalize their Part D and Medicare Advantage (MA) offerings and prepare for Medicare Open Enrollment. Additionally, CMS is announcing a voluntary demonstration to support implementation of the redesigned Part D benefit and improve stability for people with Medicare in 2025. The preliminary average Part D premiums will be released later this summer. CMS will release the 2025 landscape in mid-to-late September, as in past years, once all offerings are finalized.  Final average MA premiums and deductibles, along with other key information, are released annually in September with the… Read More

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New Medicare plans could wind up forcing seniors to switch or buy new plans or face a significant penalty

Many seniors who remain working past 65 are still on their employer’s health plan instead of government-run Medicare. However, a new update to Medicare coverage under the Inflation Reduction Act means seniors who delay joining Medicare could face additional hurdles when it comes to drug coverage. Who Does It Affect?Currently, seniors are able to avoid late penalties for Medicare Part D as long as their company’s plan pays on average just as much as the traditional Medicare prescription drug plan. These numbers are scheduled to change drastically in 2025. Starting January 1, most employer plans will no longer be accepted as a way out of the late penalties because they… Read More

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Healthcare Update: Cigna’s Negotiations with Orlando Health

Cigna Healthcare Medicare is currently in negotiations with Orlando Health in Florida. The outcome of these talks will determine if Orlando Health remains in the Cigna network. If an agreement isn’t reached, Orlando Health will exit the network on March 1, 2024. Customers will receive letters soon, detailing the change and their new assigned Primary Care Provider (PCP). For inquiries or to choose a different in-network PCP, affected customers can call Cigna Healthcare Medicare at 1-800-668-3813. The company reassures customers that their team is ready to assist, and any updates will be communicated promptly. As a reminder, you can search the online provider directory to find the most recent provider… Read More

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