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Thanks to the Inflation Reduction Act, big changes are coming to Part D that will bring relief to millions of seniors who are struggling to afford their prescription medications. Some of these changes include the new max out of pocket of $2000 on all Part D Prescription drug plans, elimination of the coverage gap, and a brand new Medicare Prescription Payment Plan. Under this new plan, if a beneficiary's copay or coinsurance is $600 or more at the register, the member can opt into the program which means they will pay their insurance plan a monthly payment to cover the cost of the drug rather than having to pay such a large amount at the pharmacy register. You will simply opt in, and pay nothing to pick up your medication at the pharmacy and your plan will bill you monthly in addition to your premium. This all sounds great in theory, but we know that in life, nothing is free and if insurance companies are paying more of the bills upfront as well as everything after the $2000 max is met, we can expect to see an increase in monthly premiums right out of the gate. Rates will be released in September and members will receive their annual notice of changes by the end of September letting them know what their new premium costs will be for 2025. If your plan is coming in high, its crucial to review your options during the annual election period which runs October 15- December 7th. Lastly, no good deed goes unpunished. While the $2000 cap on Part D costs goes into effect, this causes a new and very serious issue for consumers who have chosen to remain on their employer coverage after age 65. Medicare allows you to delay enrollment into Part D as long as your employers coverage is considered creditable, meaning its just as good or better than Medicares. Typically, these employer plans have met these requirement. Now that Part D plans will have the $2000 max out of pocket, this will most likely be better than most employer plans on the market who combine medical and prescription annual max together and are generally way over $2000 a year. This means if someone chooses to stay on employer coverage after age 65, and the coverage is not credible, when they retire and come off that plan, they will incur a late enrollment penalty which will continue for their lifetime. To avoid this, consumers should check with their employer before making the decision to remain on their plan, and if the coverage is not credible, they should enroll into part D at age 65, even if they delay Part B and stay on the medical coverage, to avoid a late enrollment penalty. With change, comes more responsibility to do your homework so that you are not caught off guard with the new rules, good or bad. Reach out to your agent or broker or give us a call to help you navigate this ever changing market.

Losing a loved in is one of the hardest things we will ever go through in this life. It comes with an overwhelming amount of emotions and can create a burden for those left behind. Just navigating our daily life can feel like an impossible task let alone tackling the lists of things to do next. We have attached a checklist that you may find helpful in your time of need. In order to plan ahead and alleviate this stress for your family or loved ones when its your turn, you may want to consider a preneed funeral plan. This allows you to make sure that your final wishes are carried out exactly how you want them. It also helps your loved ones by alleviating the emotional stress of making those hard decisions and the financial stress of paying for it when they are already grieving. The plans are easy to put together and we will guide you through the entire process. They also have flexible payment options and allows you to finance your plan up to 10 years. Its the ultimate gift to your family. To Learn more about our preneed funeral plans, please contact our office at 805-888-1544 or email us at Tonya@coastcitiesins.com

SilverSneakers is a nationwide program available to seniors on Medicare that provides a free membership to any of their participating gyms. We have lots of great gyms here on the central coast that participate in this program, with one of the most popular being Pismo Beach Athletic Club in Pismo Beach, California. This gym offers everything you can imagine including Pickleball courts and a beautiful new swimming pool. Some of the participating gyms in California are Fitness 19, Planet Fitness, YMCA, Crunch Fitness, InShape, 24 Hour Fitness, Curves, LA fitness and many more depending on where you live. When you become a member, you can visit any gym, anytime. Just show your ID card and your'e in! Not ready to go back to a crowded gym? This program also offers online classes and at home fitness kits. If you are currently a member of a participating gym and would like to see if we can find you a Medicare supplement or Medicare Advantage plan that offers Silversneakers to pay for your membership, contact us today and we can get you started!

Medicare Advantage plans are gaining popularity every year and one BIG reason they are so attractive are all the zeros! Many plans have $0 premium and $0 or low copays for most services. But before you get too excited, there are some things you should know. You may only enroll into plans available in your zip code. You must continue to pay your Medicare Part B premium, even if you join a $0 monthly plan. Be sure to understand the difference between an HMO and PPO plan. An HMO will require that you only see providers in the plans network, get referrals to specialists and there is only coverage for emergencies outside your plans service area. A PPO will allow you to see providers in network and out of network without referrals, however, your copays, coinsurance and max out of pocket will generally be much higher when accessing out of network providers. Medicare Advantage plans are tied to enrollment periods. Once enrolled you can generally only change plans at the annual election period or the Medicare Advantage Open Enrollment period or if you have a Special Election Period. Not every Medicare Advantage plan includes drug coverage, and if you go without creditable drug coverage for more than 63 days, Medicare can impose a late enrollment penalty when you enroll back into a plan with drug coverage. These plans do not require medical underwriting but if you dislike the plan and want to change to a Medicare Supplement, you will have to medically qualify unless you have a special guarantee issue situation. Not all plans include the same extra benefits you see on TV so be sure to fully understand the summary of benefits for each plan you are considering. Each plan can cover prescriptions differently so be sure to confirm your medications are covered and what your estimated costs will be before you sign up. Some plans are designed for people with special needs such as a chronic illness or Medicaid eligible so be sure to confirm any eligibility requirements before enrolling. Medicare Advantage plans change every year, so even if you are happy with your plan, you must always review your Annual Notice of Change in September for the following year so you are aware of any new benefit or cost changes. These plans can be great but they are not for everyone so do your homework, ask the experts for guidance and remember, nothing is ever free.

Introduction The Biden Administration unveiled the first 10 prescription drugs that will be subject to price negotiations between manufacturers and Medicare. His goal is to make costly medications more affordable for older Americans. The agreed upon prices for the first round of drugs are scheduled to go into effect in 2026. Here are the 10 drugs: Eliquis made by Bristol-Myers Squibb, used to prevent blood clotting and reduce risk of stroke. Jardiance made by Boehringer Ingelheim used to lower blood sugar for people with type 2 diabetes. Xarelto made by Johnson & Johnson used to prevent blood clotting and reduce risk of stroke. Januvia made by Merck used to lower blood sugar for people with type 2 diabetes. Farxiga made by AstraZeneca used to treat type 2 diabetes Entresto made by Novartis used to treat certain types of heart failure. Enbrel made by Amgen used to treat rheumatoid arthritis. Imbruvica made by AbbVie used to treat different types of blood cancer. Stelara made by Janssen used to treat Chrohn's disease. Fiasp and Novolog insulins made by Novo Nordisk. These are among the top 50 drugs with the highest spending for Medicare Part D. These 10 medications accounted for $50.5 billion, which is about 20% of the total Part D presciption drug costs from June 1, 2022 to May 31, 2023 according to CMS. Negotiations are underway and will end August 2024. Agreed upon prices will go into effect January 2026. Drug makers have currently filed law suits and declaring the policy unconstitutional. If a drug maker declines to negotiate they must pay an excise tax of up to 95% of its US sales or pull the drugs from the Medicare and Medicaid markets.