Nebraska retirees can review Medicare coverage during open enrollment

Rules for companies representing Medicare plans


Older Americans can now join, change, or drop a Medicare plan or change drug coverage in Medicare Part D or Medicare Advantage plans for the next year.

Because plans change each year, people should review what they have during that time, said Mike Carsey, a volunteer and board president of Volunteers Assisting the Elderly.

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Beneficiaries’ medications may have changed, he said. And even if they aren’t, the contracts covering these drugs may have changed. “There may be savings on the table that they can take advantage of if they shop around,” said Carsey, whose organization serves as the office for the federally funded Nebraska Health Insurance Assistance Program covering Douglas, Sarpy, Cass counties , Washington and Dodge.

If beneficiaries like what they have, they can keep those plans. If they don’t make a change, their current plan will automatically roll over into the next year.

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Medicare Advantage enrollees should check to see if their provider will still be in their plan next year, Carsey said.

Volunteers Assisting Seniors, like other similar offices around the state, is staffed by trained and certified volunteers who provide free, impartial consultations to Medicare-eligible clients seeking help comparing plans. Open enrollment began Saturday and runs through December 7.

“All we do is help people navigate the murky waters of Medicare,” Carsey said. The Omaha-based office employs between 1,000 and 1,200 people annually. Volunteers help beneficiaries save about $1 million a year.

Next year, the top deductible for a Medicare Part D prescription drug plan will be $505, up from $480 this year, he said. Although this is the maximum set by the government, many plans will have lower deductibles based on the combination of drugs the beneficiary uses and the pharmacy they choose.

Beneficiaries don’t want to choose a plan based on premium alone, Carsey said. Volunteers will use Medicare.gov’s plan finder to help them identify the cheapest option in terms of total costs, including premiums and drugs.

In another change for next year, the federal deflation law will limit copays for a one-month supply of insulin to $35. Plans are not required to cover all FDA-approved insulins, but are required to cover one pen form and one vial form of insulin in all four classifications at this rate. Some plans will also offer insulin at a lower cost.

Also under the law, Medicare will begin negotiating the prices of some expensive drugs, Carsey said. That change won’t start until 2026, and negotiations will be limited to 10 expensive drugs that have yet to be identified.

Starting in 2025, the law also puts a $2,000 cap on out-of-pocket drug costs under Part D. Carsey said some people have concluded that means the drug coverage gap, also known as the donut hole, will disappear. Whether that will happen, however, has yet to be decided.

Carsey said the organization conducts most counseling over the phone. To contact other similar groups around the state, call 800-234-7119.

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