Important Information About Medicare Plans in Central Pennsylvania

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Due to recent CMS updates, most Medicare plans in central Pennsylvania have experienced multiple changes affecting coverage and benefits such as, but not limited to:

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1. Increased Co-Pays: MANY plans now have higher co-pays and/or out-of-pocket costs.

2. Limited Formularies: Fewer prescription drugs are covered. However, note that the annual max out-of-pocket cap is favorably lower at $2,000.

3. Reduced or Removed: Extra benefits such as dental, over-the-counter products, etc. have scaled back or are completely eliminated.

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Considerations for Changing Your Medicare Plan

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When thinking about switching Medicare plans to regain lost benefits, it is important to understand the following:

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• Trade-offs Are Inevitable: Gaining a specific benefit might require sacrifices in other areas such as prescription drug coverage, higher premiums, network accessibility, and overall out of pocket medical expenses.

• Net Benefit Analysis: Changing plans solely for a lost benefit doesn't always result in an overall advantage. Evaluate the full spectrum of what each plan offers and what you stand to gain or lose. Just because a plan has a higher premium does not mean it has more comprehensive coverage.

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Our Recommendation:

Despite these changes, many of the carriers we've recommended in the past continue to be strong and competitive options in the marketplace. Our general advice is to renew your current plan if you have been satisfied with it thus far. Continuity can often provide stability and familiarity with your healthcare management. However, our office plans to contact some clients who we've identified as having some concerning plan changes leading into 2025 (via email or post). Please be patient with us as we address clients' needs.