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Some key facts from a recent George Kaiser Family Foundation article: *More Medicare Part D Enrollees Are in Medicare Advantage Drug Plans Than in Stand-alone Prescription Drug Plans * The average monthly premium for Part D drug coverage is 4 times more in PDPs than in MA-PDs ($40 vs. $10) * The weighted average annual Part D deductible is 7 times larger in PDPs than in MA-PDs * 6/10 people receiving extra help for their drug costs are enrolled in a Medicare Advantage Plan 

📢 Big News for Medicare Advantage & Part D Programs for 2025! 🚀The Centers for Medicare & Medicaid Services (CMS) has officially finalized the updates for the Medicare Advantage (MA) and Medicare Part D Prescription Drug Programs for 2025. Here's what you need to know: ✅ Payments to MA plans are set to increase by an average of 3.70%, which translates to over $16 billion, ensuring that the federal government continues to support these vital programs efficiently, with payments estimated between $500 and $600 billion. ✅ Big wins for those on Medicare Part D, as improvements are finalized to significantly lower drug costs. Thanks to the Inflation Reduction Act, out-of-pocket costs will be capped at $2,000, leading to substantial savings. 🗣️ HHS Secretary Xavier Becerra highlighted, "This ensures millions will see lower costs next year, with a cap on out-of-pocket expenses for prescription drugs at no more than $2,000." 🔍 The Rate Announcement and Part D Redesign Program Instructions include updates to keep MA payments accurate, ensure sustainable prescription drug costs, and provide robust healthcare options. 📌 For a detailed look into the CY 2025 Rate Announcement and the Final CY 2025 Part D Redesign Program Instructions, visit CMS's official pages.Let's celebrate this significant step towards making healthcare more affordable and accessible! 🎉#MedicareAdvantage #PartD #HealthcareNews #InflationReductionAct #CMS2025 https://lnkd.in/eF2rDJm6

Definitely worth the read. Medicare Advantage and prescription drug programs to remain stable. Average premiums, benefits, and plan choices for Medicare Advantage and the Medicare Part D prescription drug program will remain stable in 2024, the Centers for Medicare and Medicaid Services has said. #cms #medicareadvantage #meicaid #medicarepartD

Key Facts About Medicare Part D Enrollment and Costs in 2023 by Juliette Cubanski and Anthony Damico KFF The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone prescription drug plans (PDPs) to supplement traditional Medicare and Medicare Advantage prescription drug plans (MA-PDs) that include drug coverage and other Medicare-covered benefits. This brief analyzes Medicare Part D enrollment and costs in 2023 and trends over time, based on data from the Centers for Medicare & Medicaid Services (CMS). This analysis highlights the substantial growth of Medicare Advantage drug plans in the marketplace for Part D drug coverage, where enrollment overall is concentrated in a handful of large plan sponsors. Average premiums and deductibles for drug coverage are much lower in MA-PDs than in stand-alone PDPs. Cost-sharing requirements for covered drugs in MA-PDs and PDPs are different, making comparisons of out-of-pocket drug costs difficult. While lower premiums can make MA-PDs attractive to enrollees, coverage in a Medicare Advantage plan also comes with limits on provider networks and utilization management restrictions that do not apply in traditional Medicare. https://lnkd.in/eTr8eJR2

In 2023, more than half of all Medicare Part D enrollees (56%, or 28.3 million) are enrolled in MA-PDs and 44% (22.2 million) are enrolled in stand-alone PDPs, continuing a trend of declining enrollment in PDPs and increasing enrollment in MA-PDs, reflecting enrollment growth in Medicare Advantage plans overall (Figure 1, Table 1).

CMS Finalizes Payment Updates for 2025 Medicare Advantage and Medicare Part D Programs On Apr 01, 2024, the Centers for Medicare & Medicaid Services (CMS) announced significant updates to the Medicare Advantage (MA) and Medicare Part D Prescription Drug Programs for 2025, focusing on payment policies and beneficiary protections. The finalized Calendar Year (CY) 2025 Rate Announcement aims to enhance payment accuracy and reinforce safeguards for individuals relying on MA and Medicare Part D coverage. It complements previously proposed rules for CY 2025, which will be finalized soon to strengthen protections for beneficiaries. One key aspect of the announcement is the projected increase in government payments to MA plans by an average of 3.70 percent, amounting to over $16 billion from 2024 to 2025. This reflects the government's commitment to supporting private health plans in providing quality care to Medicare beneficiaries. Additionally, CMS is implementing improvements to the Medicare Part D drug benefit structure for 2025. Thanks to the Inflation Reduction Act, signed into law by President Biden, annual out-of-pocket costs for Medicare Part D beneficiaries will be capped at $2,000 in 2025, resulting in significant savings. HHS Secretary Xavier Becerra emphasized the positive impact of these changes, stating they will put more money back into the pockets of Medicare Part D enrollees. He reiterated the administration's dedication to reducing healthcare costs for all Americans. CMS Administrator Chiquita Brooks-LaSure highlighted the agency's commitment to maintaining stability and enhancing the Medicare Advantage and Part D programs. The finalized policies seek to ensure accurate payments, lower prescription drug costs, and provide robust and affordable healthcare options for Medicare beneficiaries. The Rate Announcement for 2025 includes updates to MA payment growth rates and changes to payment methodologies, incorporating the latest fee-for-service payment data and ongoing improvements to the risk adjustment model. These changes are crucial for keeping the programs up-to-date and improving payment accuracy. Furthermore, CMS Deputy Administrator Meena Seshamani, MD, Ph.D., expressed satisfaction with finalizing guidance on the new $2,000 out-of-pocket cap for prescription drugs under Medicare Part D in 2025. This provision, part of President Biden's prescription drug law, will offer meaningful cost savings and relief to enrollees facing high and increasing drug costs.

What is this Medicare Drug Hubbub all about? In order to improve the affordability of medications for those 65 and older with Medicare Part D, the Centers for Medicare & Medicaid Services (CMS), announced the first 10 drugs covered under Medicare Part D selected for negotiation as part of the Inflation Reduction Act. The drugs chosen include the 10 drugs with the highest gross annual spending total, accounting for $50.5 billion in total Part D gross covered prescription costs per year and more than $3.4 billion in out-of-pocket costs. There are four diabetes medications included among the ten drugs named for price reductions in this first go-round, which if approved, would take effect in January 2026. Learn which diabetes meds are included and gain additional insights on this affordability initiative with the experts by clicking the link below. #BoardCertificationinAdvancedDiabetesManagement #CertifiedDiabetesCareandEducationSpecialists #CDECoach #BCADM #CDCES #RegisteredDietitian #RegisteredNurse #DiabetesedServices #cdcescoach #diabetesawarenessmonths #pharmacist #diabetesmanagement #training #rn #rd

"Today, the Centers for Medicare & Medicaid Services (CMS) announced that average premiums, benefits, and plan choices for Medicare Advantage and the Medicare Part D prescription drug program will remain stable in 2024." "Additionally, thanks to the Inflation Reduction Act, people with Medicare Part D prescription drug coverage will continue to have improved and more affordable benefits, including a $35 cost-sharing limit on a month’s supply of each covered insulin product, recommended adult vaccines at no cost, and additional savings on their Medicare Part D drug coverage costs in 2024."  https://lnkd.in/grEtYtfK #medicare #medicareadvantage #medicarePartD #RebellisGroup

The Centers for Medicare and Medicaid Services (CMS) issued an advanced notice for the Medicare Advantage (MA) and Medicare Part D Prescription Drug programs on 31st January 2024, outlining proposed updates to payment policies for these programs in Calendar Year (CY) 2025. This notice complements a proposed rule released in November 2023 aimed at enhancing protections for individuals reliant on MA and Medicare Part D coverage. If finalized, the proposed changes would lead to an average increase of 3.70 percent, totaling over $16 billion, in government payments to MA plans from 2024 to 2025. The Center for Medicare and Medicaid Services (CMS) is planning enhancements to the Medicare Part D drug benefit for 2025, aimed at reducing drug costs for millions of Medicare beneficiaries. This includes the introduction of the Draft CY 2025 Part D Redesign Program Instructions. Notably, the Inflation Reduction Act will cap annual out-of-pocket costs at $2,000 for individuals enrolled in Medicare Part D starting in 2025. Health and Human Services Secretary Xavier Becerra reaffirmed the administration’s commitment to ensuring affordable prescription drugs, stating that steps are being taken to lower costs, preventing individuals from facing the dilemma of choosing between medication and basic needs. The Biden-Harris Administration aims to optimize care for the millions enrolled in Medicare Advantage plans and ensure efficient use of taxpayer funds. Read More below: - https://lnkd.in/evjk2t8f #medicalbilling #medicaid #medicareadvantage #GlobeCentrix

The Inflation Reduction Act is making changes to how people with Medicare prescription drug coverage (Medicare Part D) pay for their medications. Starting in 2025, they'll have the choice to spread out their prescription costs over the whole year instead of paying a lot upfront. This is good news for seniors and people with disabilities because it can help them deal with high drug costs. The Centers for Medicare & Medicaid Services (CMS) released some draft guidelines to get feedback from people about how this new payment plan should work. The guidelines talk about things like who can benefit from this plan, how people can sign up for it, and how data will be collected to see how well it's working. They want people to share their thoughts, and the final plan will come out in 2024. This new payment plan is part of the President's efforts to make prescription drugs more affordable for people with Medicare. #Medicare #PrescriptionDrugs #AffordableMeds #MedicarePartD https://lnkd.in/gRUKaAJD