Up Next for 2026! The First 10 Drugs with Negotiated Prices

Up Next for 2026! The First 10 Drugs with Negotiated Prices

One of the biggest challenges Independent Brokers have with clients regarding plan selection is the cost of their prescription drugs. This has been an ongoing problem for many and can drastically affect access to affordable health care plans. The steep price tag on medications such as Eliquis and Jardiance has also led to problems accessing these lifesaving and sustaining drugs. Clients have shared in some cases that they just won’t take their medication. They simply cannot afford it. While there are other options for financial assistance we can seek out, not everyone qualifies. Strides have been made so far to address this including the $2000 annual cap on drug copays that began this year. However, more is coming! So, what is on tap next to address this issue?

Under 65 with Medicare? New Coverage Options in Indiana

Under 65 with Medicare? New Coverage Options in Indiana

There are many individuals that become eligible for Medicare under the age of 65 if they have been disabled and getting Social Security Disability Income for two years. They are automatically enrolled in Medicare A and B effective on the 25th month of their disability payments. However, until 2025, these people were limited in their benefit options with Medicare. Last Spring, a new bill was introduced and passed for Medicare beneficiaries under the age of 65 giving them more options for supplemental coverage in Indiana. [See SEA 215 bill: https://www.in.gov/ship/files/SEA215_release1.pdf] Keep reading for more on this latest development in our state!

Sticker Shock at the Pharmacy? 3 Strategies to Help

Sticker Shock at the Pharmacy?  3 Strategies to Help

Early in the new year in 2025, I have already received several calls from clients surprised and worried about the high cost of their first prescription refill.  These are the same drugs they have always been on, so why in the name of happy pills is the cost suddenly so high?  What happened and is there anything that can be done?  Well, read on for both an explanation and some helpful tips to manage those costs!

Federal Retiree Plans and Medicare

Federal Retiree Plans and Medicare

This is essentially part II of a previous blog explaining how employer retiree benefits work compared to Medicare benefit options.  See blog: https://www.cdi-cares.com/blog/employer-retiree-plans-and-medicarewhat-you-should-know.  In this blog, we are going to dive deeper into Federal Retirees specifically.  Federal Retirees include people who worked for and retired from government/legislative offices, military bases, post offices, etc. These individuals have access to a special benefits program that includes medical, prescription drug, dental, vision and hearing benefit plans.  Some have access to plans as early retirees before turning 65, and others have special plans for over the age of 65 and retired.  However, there are cost and coverage restrictions to be aware of.  In some cases, it may be beneficial to combine these benefits with Medicare or not use the Federal Retiree offering at all.  Let’s explore…..

Employer Retiree Plans and Medicare—What You Should Know

Employer Retiree Plans and Medicare—What You Should Know

With the volume of retirees from the Boomer generation and loads of people still turning 65, there are still many that have the option of a retiree medical benefit through their previous employer.  Along with this type of offering comes a lot of questions about choices and cost comparisons.  Myth-Buster Alert!!  Your retiree plan is not always the best and lowest cost option!  Another important piece to know is that most plans still require enrollment in Medicare Part A and B through Social Security.  So, you will still be paying a monthly premium for Medicare Part B.  The retiree plan usually functions just like a Medigap (supplement) or Advantage Plan.  Read on to see if this applies to you or a loved one needing guidance on the most cost-effective way to handle your health coverage in retirement.

What’s Coming in 2025…..

What’s Coming in 2025…..

Each year as we head toward the last quarter of the year, the Center for Medicare/Medicaid Services or ‘CMS’ announces changes to Medicare for the coming year.  However, with the changes in 2025 having such a widespread impact, everyone has already been talking about it.  We have already had seminars, webinars, in person conferences and analysts have put out videos earlier this year.  Why does 2025 seem to have such a shock appeal?  This is because Medicare will have the biggest change to Part D since its inception in 2006.  So, what is coming up for 2025, and how could it affect you?  Here is a sneak peak at the good and the potentially bad.

Medicare or Medicaid—What is the Difference?

Medicare or Medicaid—What is the Difference?

Having worked in the Senior Healthcare market in one form or another for over 20 years, I am surprised that I can still get confused at the difference between Medicare and Medicaid.  It is not easy for everyone to grasp.  I recently cultivated a wonderful networking relationship with a Medicaid Specialist who works for a reputable elder law firm.  During our discussions, we realized there are a lot of myths and mysteries related to Medicare and Medicaid.  Now, is this a riveting topic?  No, but it is important to a lot of people!  So, let’s do a brief review of the basics to help distinguish between these two important services.

Medical Necessity or Cosmetic?

Medical Necessity or Cosmetic?

I frequently get calls from clients about why something that seems so basic is not covered by their Medicare plan.  It happens whether you are on Original Medicare with a stand-alone prescription drug plan or on an all-inclusive Advantage Plan.  This is true of prescription drugs, medical procedures, lab tests, alternative medicine and dental procedures.  The basis for the decision to not cover something boils down to whether that drug or service is considered medically necessary, has an effective alternative, or could be considered cosmetic.  Based on questions from you, here are some common non-covered items or services that might surprise you.  It is very likely that one of these things will come up for you too, so read on.