Thomas M. Brzezinski is one of the founding partners of WMAG William & Michael Advisor Group LLC and Jersey Insurance Solutions. He has been involved in the insurance industry for over ten years and specializes in developing client relationships that last a lifetime.
The Time Is Now To Educate Yourself And Talk To A Local Professional
Advice From Thomas Brzezinski and Craig Hansen,
Co-Founders, Jersey Insurance Solutions
Medicare Insurance Professionals/Advisors
https://jerseyinsurancesolutions.com • 973.500.3708
Medicare Part D Changes Are Coming In 2025 – What Consumers Need To Now
“The Time Is Now To Educate Yourself And Talk To A Local Professional”
The Inflation Reduction Act has resulted in some wins for consumers – most notably capping insulin drug prices at $35 per month. But capping drug prices often means those costs will be made up elsewhere, most likely in the form of much higher premiums.
“That’s what likely is going to happen is some prescription drug plans will double or even triple in price,” Thomas Brzezinski, Co-Founder of Jersey Insurance Solutions, and an expert Medicare advisor. “We won’t know exactly how much until Oct 1st when the insurance companies officially announce the new rates that will go into effect in January. But right now is the moment when consumers need to think about this.”
Here’s what we know now:
- Part D plans are changing. The biggest change centers around capping out-of-pocket drug costs at $2,000. This is good news for seniors. However, the boomerang effect will likely be seen in the form of increased premiums. Brzezinski estimates that some plans for New Jersey residents could double or even triple. A significant change for seniors on fixed incomes.
- Those changes will affect both Medicare Part D plans (supplemental drug plans within Medicare) and Medicare Advantage (plans that operate more like a traditional employer health insurance plan with in-network doctors/hospitals). For both, increased benefits and/or removal of add-on benefits, such as dental, vision, transportation, discounts on over-the-counter drugs, and higher deductibles on hospitalizations, are likely to happen. Again, no one knows how much until October 1st when insurance companies announce the specific changes, which then go into effect in 2025.
- What you need to do now is review your coverage, regardless of whatever plan you are currently in. Don’t just hit repeat. Talk to a local professional (emphasis on local) who will take the time to analyze your current health needs and income and find the right options for you.
A Conversation With… Thomas Brzezinski, Co-Founder of Jersey Insurance Solutions
January 2025 means big changes to Medicare Part D and Medicare Advantage drug plans. We spoke to Thomas Brzezinski, Co-Founder of Jersey Insurance Solutions about those changes and what consumers need to know to avoid sticker shock in the Fall.
Q: So, what’s happening now with Medicare?
TB: As part of the Biden administration’s Inflation Reduction Act, they’ve addressed the rising cost of prescription drugs, which is a good thing for consumers. Insulin was capped last year at $35 per month, and next year they’re capping out-of-pocket drug expenses at $2,000 per year, all of which are good for seniors. The concern now is how consumers will bear the cost of those caps, because it’s a safe bet the drug companies likely won’t. That will likely mean increased premiums and/or reductions in benefits.
Q: Increased by how much?
TB: That’s the million-dollar question – no one knows until October 1st when the insurance companies formally announce their new rates, which will go into effect in 2025. Until then we can only speculate. In my professional opinion premiums for Part D plans are going to increase drastically. Most of them are going to double, possibly triple. There are plans in New Jersey for seniors now that cost as little as $7 per month, some are even free. I can see those becoming closer to $50-60 per month. That’s a hefty increase for someone on a fixed income with existing health issues.
Q: So given that, what do you see happening as a result?
TB: I think seniors are going to start seriously considering options like Medicare Advantage. If you’re a senior in good health and your doctor is in-network or you’re taking generic drugs, Medicare Advantage plans can be a lot more attractive. This is where education is key for people to understand what’s happening and talk to an advisor who can assess your individual needs and find a plan and supplemental policies tailored just for your health and budget.
Q: What else can consumers do?
TB: Simply put, they need to review their coverage with a local professional long before January 1st. I stress the word local because coverage options and costs vary by state, and talking to a local agent ensures they understand those nuances. Call center operators are reading from a script designed to enroll you in their plans, not help you find the solution that is perfect for your needs. For example, if you get diagnosed with cancer and need chemotherapy you are actually responsible for 20% of the cost up to your max out-of-pocket. That can be close to $8,000! The good news is there are supplemental policies that will cover those costs. That’s why sitting down with a local professional is crucial in assessing your specific health needs.
Q: Any final thoughts?
TB: These changes are going to be big and they’re going to affect everyone on Medicare. Consumers need to find someone to help them manage all of this because in 2025 everything is going to be different. Educating yourself and having a local ally to help you navigate is the best thing you can do.
