More than two-thirds of Medicare beneficiaries have multiple chronic conditions, such as cancer, diabetes, heart disease, kidney disease and lung disease.
Although original Medicare and Medicare Advantage provide coverage for these conditions, some plans now offer additional benefits. And special needs plans (SNPs) designed for Medicare Advantage enrollees with chronic conditions are growing in number.
Open enrollment runs Oct. 15 to Dec. 7, so that’s a good time to assess your medical and drug coverage needs. If you have a chronic condition, consider these options.
Savings for patients who need insulin
The opportunity: One in every 3 Medicare beneficiaries has diabetes, and 3.3 million beneficiaries use one or more types of insulin, according to the Centers for Medicare and Medicaid Services (CMS). The Inflation Reduction Act capped Part D and Medicare Advantage copays for insulin at $35 a month as of Jan. 1, 2023. For insulin through an external pump, which Part B covers, the cap took effect July 1, 2023.
The caveat: Not every Part D plan covers every insulin, so make sure your plan covers the type you take. The timing of the Inflation Reduction Act, signed in August 2022, made finding that information more complicated in 2023, but the problem will be resolved when you shop for 2024 plans.
The Medicare Plan Finder for 2023 plans doesn’t include the $35 monthly cap when estimating annual drug costs because insurers had already set their premiums and copays. If you take insulin, call 800-MEDICARE (800-633-4227) or contact your State Health Insurance Assistance Program (SHIP) for help choosing a 2023 plan. For 2023 coverage for people who use insulin, Medicare is extending the deadline to add, drop or change Part D coverage until Dec. 31 because of the Plan Finder problems.
When choosing a Part D plan, be sure to compare costs of all your medications, not just insulin.