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The Villages
Thursday, September 28, 2023

Many Villagers are not aware of new law that includes Medicare benefits

Many residents in The Villages are not aware that a new law includes Medicare and other healthcare benefits, according to Jim Bodenner, president, Villages Chapter of the National Retiree Legislative Network (NRLN).

The NRLN Villages Chapter was formed in September 2016. The NRLN is based in Washington, DC and is a nationwide non-partisan, non-profit organization dedicated to representing the interests of retirees and future retirees

Bodenner said he was recently invited by a law firm in The Villages to talk to their clients about Medicare and other healthcare insurance coverage. “There were individuals in the audience who were surprised to learn from me that beginning in 2023, Medicare will cap the cost of insulin at $35 per month. Everyone was pleased to hear that beginning in 2025, the amount of out-of-pocket money that Medicare Part D beneficiaries will have to pay each year for their prescriptions will be capped at $2,000.”

He explained that the U.S. Senate and House cut short their usual month-long August recess to pass legislation that included improvements to Medicare and other healthcare benefits. The Senate passed the bill on August 7 and the House passed the bill on August 12. President Biden signed the legislation into law at a ceremony at the White House on August 16.

Bodenner noted the additional benefits provided by the law along with $35 per month insulin and the annual $2,000 out-of-pocket cap for prescription drugs:

  • As of Jan. 1, 2023, Medicare enrollees won’t have any out-of-pocket costs for vaccines that the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices recommends for adults.
  • In 2024, the year before the out-of-pocket cap takes effect, Medicare beneficiaries will no longer have any out-of-pocket costs if they reach Medicare’s catastrophic coverage. The way catastrophic coverage works in 2022 is that once an enrollee’s out-of-pocket costs reach $7,050, they pay 5% of their prescription drug costs, with no limit. In 2024, the 5% coinsurance requirement will be gone, and enrollees won’t have to pay anything for their prescription drugs for the rest of the year. Also beginning in 2024 and continuing through 2029, Part D premiums cannot increase by more than 6% a year.
  • Beginning in 2025 Medicare Part D plans will offer the option for “smoothed cost-sharing”. This means Part D participants can opt to have their out-of-pocket costs spread out over the year. This is designed to protect from being hit with a big drug bill at one time that it may discourage filling prescriptions.
  • In 2026 Medicare will begin negotiating drug prices.

“Although the NRLN would have preferred that the legislation require Medicare to use the competitive bidding (business) model that it had proposed to members of Congress, it is historic that the new law will allow Medicare to eventually negotiate the price on some expensive prescription drugs,” Bodenner said. “However, the NRLN and the Villages Chapter will continue to lobby for more drugs to be included for price negotiations.”

Bodenner said he is available to speak to clubs in The Villages about Medicare. His email address presvillageschapter@nrln.org

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