Medicare Updates, Financial Assistance & Wellness Tips

Your Trusted Guide to Medicare Updates and Tips

Welcome to Our May Edition!

Spring is in full swing, and so is our commitment to keeping you informed about your Medicare options. This month, we’re sharing updates on coverage, wellness tips for the season, and ways to maximize your benefits. Let’s dive in!

Medicare Updates for 2025

As we move through 2025, here are key updates to keep on your radar:

• Medicare Prescription Payment Plan: This voluntary program, effective January 1, 2025, allows Part D enrollers to spread out-of-pocket drug costs across the year in monthly payments, rather than paying large amounts at the pharmacy. This is particularly helpful for those with high costs early in the year or for expensive medications. The plan does not reduce total costs, only redistributes them, and may not benefit those with stable, low drug expenses. If you are interested, simply call your carrier to get it setup.
• Notification of Unused Supplemental Benefits: Starting in 2025, Medicare Advantage plans must send a personalized “Mid-Year Enrollee Notification of Unused Supplemental Benefits” between June 30 and July 31. This notice lists unused supplemental benefits (e.g., dental, vision, hearing, fitness) advertised by the plan, their scope, out-of-pocket costs, and instructions on how to access them. This aims to encourage beneficiaries to utilize benefits they may not have used in the first half of the year.

Hospital Charity Care and Financial Assistance Programs

• What They Are: Many hospitals, especially nonprofit ones, are required by federal law (under the Affordable Care Act) or state regulations to provide charity care or financial assistance to low-income patients. These programs may cover part or all of a patient’s out-of-pocket costs, including Medicare Part A copays (e.g., $419 per day for hospital stays between days 61–90 in 2025) or Part B coinsurance (20% of approved amounts after the $257 deductible). Some hospitals also assist with Part D prescription drug copays.

How They Work:

• Patients must apply through the hospital’s financial assistance office, typically by submitting proof of income, assets, and insurance status (e.g., Medicare enrollment).If approved, the hospital may waive or reduce copays, coinsurance, or even entire bills for covered services. For example, a low-income Medicare beneficiary might have the $1,676 Part A hospital deductible or daily copays for extended stays partially or fully covered.Assistance is often tiered based on income relative to the Federal Poverty Level (FPL). For 2025, 150% of the FPL for a single person is approximately $22,590 annually, but hospital policies may extend eligibility up to 200%–400% of FPL depending on the institution.

Spring Wellness Tips

With warmer weather, May is a great time to focus on your health:

• Stay Active: Try outdoor activities like walking or gardening to boost your mood and fitness. Check if your Medicare Advantage plan offers gym membership or fitness programs like Silver Sneakers.
• Allergy Management: Spring allergies can be tough. Talk to your doctor about covered treatments or medications to keep symptoms in check.

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