What is one Medicare trend that you believe is having a positive impact on Medicare affordability? How is it making a difference?

Question

Terri Reagin · Accepted Answer

This answer is provided in a video format. Watch the agent's video response here: https://medicareagentshub.com/questions/what-is-one-medicare-trend-that-you-believe-is-having-a-positive-impact-on-medicare-affordability#terri-reagin

Christopher Boyd · Answer

The newest change for 2025 is No Donut Hole in the Medicare Part D patient maximum. The new limit for out of pocket prescription costs are $2000 limit. Basically, is the medication you require is covered by your Part D plan or MAPD, the new guidelines limit your maximum costs per year. Additionally, there is a new monthly payment plan option to cover high cost Brand Name medications.

Answered by Christopher Boyd on July 30, 2025

Agent Licensed in IN, KY, MI, OH, PA & TN

Answered by Christopher Boyd Medicare Insurance Agent

Mal Varlack · Answer

The top two trends that will have a positive impact is going after Medicare Fraud, Waste and Abuse. The second trend is the limits on copays for certain medications. Both of these drive up costs that are only passed on to those who truly need the help.

Answered by Mal Varlack on July 31, 2025

Agent Licensed in FL

Answered by Mal Varlack Medicare Insurance Agent

Irma Lopez · Answer

One trend is the ability to sign up for a Medicare Advantage plans (some with $0 premium).  These plans offer additional benefits such as dental vision & hearing coverage.

Vachik Chakhbazian · Answer

hese plans, offered by private companies, often provide lower premiums and out-of-pocket costs compared to Original Medicare, as well as additional benefits like prescription drug coverage, vision, hearing, and dental. This trend is making healthcare more accessible and affordable for many seniors.

Answered by Vachik Chakhbazian on July 31, 2025

Agent Licensed in CA, AL, AR & 22 other states

Answered by Vachik Chakhbazian Medicare Insurance Agent

Brenda Watson · Answer

Part D plans are a life saver for many individuals. These plans don't help if you don't take any medications, however if you're on medications they save most individuals hundreds to thousands of dollars a year.

Answered by Brenda Watson on July 31, 2025

Broker Licensed in OK & AR

Answered by Brenda Watson Medicare Insurance Agent

Jim Towle · Answer

One Medicare trend that is having a positive impact on Medicare affordability is the expansion of Medicare Advantage (MA) plans. Over the past few years, Medicare Advantage plans have seen significant growth, offering a more comprehensive and cost-effective alternative to traditional Medicare. These plans are managed by private insurance companies, and they often include additional benefits, such as dental, vision, hearing, and wellness programs, which are not typically covered by Original Medicare.

What makes Medicare Advantage plans particularly beneficial for affordability is their caps on out-of-pocket expenses, which provide financial protection for beneficiaries. Many of these plans also have low or $0 premiums, and they often offer more predictable cost structures, which can help beneficiaries manage their healthcare expenses better. Additionally, these plans frequently include prescription drug coverage (Part D), which simplifies the insurance process and often lowers drug costs compared to separate Part D plans.

The rise in value-based care models within Medicare Advantage is also helping reduce overall healthcare costs. These models focus on preventive care and more coordinated management of chronic conditions, which not only improves health outcomes but also reduces the need for more expensive treatments down the line. This trend is helping to lower costs for both beneficiaries and the Medicare system as a whole.

By offering more comprehensive benefits, a focus on preventive care, and capping out-of-pocket expenses, Medicare Advantage plans are playing a crucial role in improving affordability for Medicare recipients and ensuring they receive high-quality care without breaking the bank.

Stephen Garrard · Answer

The fact that CMS has FINALLY held PBMs’ feet to the fire and negotiated prices on some of the most outlandishly expensive and frequently used medications is potentially a major game changer. It’s only 10 meds for 2026 but there’s more on the way in coming years. Fingers crossed that it will begin to shift the power back to the Medicare patient to get the Rx care they need and not be priced out.

Answered by Stephen Garrard on July 31, 2025

Agent Licensed in UT, AZ, CO & 9 other states

Answered by Stephen Garrard Medicare Insurance Agent

What is one Medicare trend that you believe is having a positive impact on Medicare affordability? How is it making a difference?

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What is one Medicare trend that you believe is having a positive impact on Medicare affordability? How is it making a difference?

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