Adams Insurance Management (AIM) understands the complexities involved in selecting a suitable health insurance plan and is dedicated to providing personalized assistance and expert guidance to help clients navigate through their options. Specializing in Medicare advantage, Medicare supplemental, stand-alone drug policies, and individual insurance policies for individuals under 65, AIM aims to streamline the process and empower clients to make well-informed decisions about their coverage. The team at AIM prioritizes tailored solutions, attention to detail, and a personalized approach to address clients' needs and uncertainties with professionalism and expertise.
For individuals new to Medicare, the process can be overwhelming with an abundance of information from various sources. Whether through in-person consultations, virtual meetings, or telephone conversations, we are committed to providing comprehensive education and guidance to bring clarity to the confusion surrounding Medicare enrollment.
Medicare recipients are likely to face a "perfect storm" this enrollment season, Starting next year, Medicare is set to undergo some major changes, and seniors on Medicare might need to make different decisions when it comes to their health care plans. As we approach this year's Annual Enrollment Period (AEP), it's evident that the process will be more complex and overwhelming than ever before," "We're facing a 'perfect storm' of challenges—a presidential election that will distract beneficiaries during the critical early weeks, a late Thanksgiving that compresses decision-making time, and significant market changes."
7 Medicare Changes You’ll See in 2025
One of the biggest changes takes effect in 2025, when Part D plans must cap out-of-pocket spending on covered drugs at $2,000 a year. That change will have a ripple effect on Part D and Medicare Advantage plans’ other costs and coverage, making it especially important to review your options during open enrollment this year.
$2,000 out-of-pocket spending cap for prescriptions
In 2025, Part D plans can have a deductible up to $590. Then you pay copayments for your medications until your total out-of-pocket costs reach $2,000.
No more Part D ‘donut hole’ or coverage gap
This change simplifies the way Part D works. Before 2025, plans had four coverage phases.
Deductable, Intial coverage, Coverge gap and Catastrophic coverage
More ways to get weight loss drugs
Medicare is prohibited from covering drugs prescribed specifically for weight loss. But Part D plans can cover popular weight loss drugs when they’re ordered for other purposes, such as Ozempic and Mounjaro for type 2 diabetes.
Subtle changes to your Medicare Advantage coverage
Medicare Advantage plans may make changes in 2025 to help cover their additional expenses.
Midyear statement from your Medicare Advantage plan
The midyear statement will show available benefits that you haven’t used
Expanded program for family caregiver services
A program for dementia patients and their caregivers that launched this year will quadruple in 2025, serving more of the country.
Important criteria. Participants must be enrolled in original Medicare and have a dementia diagnosis. They can’t be in hospice or a nursing home.
A push to add more mental health providers to Medicare
Medicare Advantage plans must meet stricter standards to improve access to behavioral health specialists.
The caveat. Medicare Advantage plans may make changes in 2025 to help cover their additional expenses. A plan may Change its formulary , which is its list of covered drugs; increase the percentage you pay for some services, called coinsurance; or reduce some of the extra benefits that drew you to the plan in the first place.
The bottom line: You may see a big variation in premiums, copayments and covered drugs during open enrollment this year.
We provide the flexibility of scheduling appointments that suit your preferences, whether it be in-home, virtual, or over the phone. We will help you make the right choices for your needs.
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