As Medicare’s annual Open Enrollment Period (October 15 – December 7) nears, enrollees might notice a few notable changes to the system since last year. As news continues to pour in around each of the new adjustments to Medicare, it can be difficult to fully understand what each change means and how beneficiaries are affected.

The primary legislation behind these adjustments is the Inflation Reduction Act of 2022, which was signed into law on August 16. As new policies roll out in the coming decade, it’s important to note that Medicare’s benefits will remain largely the same. Among the most consequential changes include:

• Prescription drug price provisions for Medicare address rising drug prices across the nation, which have been a top concern among many Americans, and particularly older Americans enrolled in Medicare. Beginning in 2023, drug companies will be required to pay rebates for drug price increases faster than inflation. This move is intended to help thwart annual increases in drug prices for both Medicare beneficiaries and those with private insurance.

• Importantly, the federal government will be able to negotiate prices of high-cost drugs (namely brand-name drugs that do not have generic or biosimilar equivalents) covered under Medicare Parts D and B.
• Across the plan’s implementation timeline (2023-2029) are a few more changes that will benefit Medicare recipients:

– Out of-pocket drug costs under Part D will be capped at $2,000 annually, providing some financial relief for those who spend thousands of dollars out-of-pocket each year on necessary medications.

– Insulin copays will be limited to $35 per month.

– And in 2024, more Americans will become eligible for low-income subsidies (LIS).

Medicare hasn’t seen such consequential systemic changes in decades, and it’s significant that policymakers are trying to remedy some of the program’s longstanding issues. Despite these efforts, these provisions will most likely move at a glacial pace and largely not come into effect until 2025 or beyond.

So, what else should we be prioritizing now? It’s clear that more needs to be done, and the enrollment process is an obvious starting point.

A recent Medicare report revealed that less than a third of respondents “strongly agree” that they can effectively select a Medicare plan, while only 20% said they had a solid understanding of Medicare itself.

The complexities of enrollment and the general lack of clarity around Medicare itself are increasingly becoming the program’s two most profound pitfalls. It’s up to us in the market to promote a broader understanding of the complex Medicare ecosystem.

It’s why at Hella, we’re intentional about being an all-encompassing resource for older Americans at all points along their Medicare journey. Hella’s articles and guides help explain the fundamentals and address the common confusion points, while Hella Health simplifies individualized plan enrollment.

Hella Health’s Eligibility Wizard provides users with updates on plan enrollment windows, so beneficiaries are up to date on crucial timelines. As Hella Health continues to grow, we are adding AI-powered tools that will help users track drug price changes so that they can stay on top of the fluctuating healthcare market.

While the recent flurry of Medicare-related legislation is a welcome reprieve from some of Medicare’s lingering issues, these common headaches will not go away overnight. Hella Health recognizes that older Americans need help in the here and now, and we’ll continue working towards improving the fundamentals to deliver the best possible Medicare experience for all.

Author Bio: Rafal Walkiewicz is the CEO and founder of Hella Health, the first 100% digital platform built to educate and enroll customers in Medicare plans. Rafal has a track record as a thought leader in the insurance industry. His innovative thinking and expertise in insurtech trends set him apart as a disruptor in a sector where change is long overdue. You can read some interviews here: https://bit.ly/3bMhGhz and https://bit.ly/3vVjzj0