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This article was first posted October 1, 2025. The open enrollment period for Part C Medicare Advantage and Part D Drug Plans starts on October 15 and runs through December 7, 2025. If you're 64 or older, your residential mailbox is probably already overflowing with sales materials and your cellphone is running hot from the spam marketing calls. Administration policy favors pushing Social Security beneficiaries into the much higher skim rates for Medicare Advantage, rewarding big campaign contributors in the insurance industry. Goosing Medicare Part D premiums is one way to do it. {{ The premium stabilization demonstration will continue for another year under the Trump administration, but with reduced support to PDP sponsors in 2026. The monthly premium subsidy will be reduced from $15 to $10, and the limit on the PDP monthly premium increase will rise to $50 for 2026, up from $35 for 2025. The risk corridor component of the demonstration is being eliminated. In announcing these changes, CMS states that it is “facilitating the [Part D] program’s return to operating under regular market conditions.” Increasingly, however, these regular conditions appear unfavorable to the ongoing stability of the stand-alone prescription drug plan market, further tilting the playing field for coverage towards Medicare Advantage. }} In spite of the rising costs, you may still be able to get a stand alone Part D drug plan with a $0/month premium in 2026. I chose Wellcare's Value Script plan for 2025, and it was the least expensive Part D plan I've had so far. For 2026 they are maintaining the $0/month premium, but have raised copays in some Tiers and have a reputation for overcharging on drug prices. As long as most of your drugs fall in the "Tier 1 preferred" category with the $0 copay, it's a good deal. As always, you should approach the Medicare Part D marketplace with caution. First, you need to know your real drug costs by checking your medication prices on GoodRx and Mark Cuban's Cost Plus Drugs. Second, enter your list of medications in the Medicare online Part D drug plan finder (which should be available starting October 15th.) For those drugs where the Part D drug plan is charging you more than the GoodRx price, consider paying cash with a GoodRx coupon and cutting the insurance company out of the transaction. Third, if you take an expensive medication that will drive your drug costs over $2,000/year, you probably don't need to worry about GoodRx. It will be cheaper to just pay the price the insurance company charges and have all your drug costs count towards your $2,000 annual limit ($2,100 for 2026.) Approximately 20% of beneficiaries fall in this category. What to conclude from these findings? Medicare appears to be inexorably moving to services where more of your money is spent on sales commissions and admin costs, and less on actual medical services for beneficiaries. There are still ways to protect yourself, but it's taking more work and time your part. Resources for additional information.True Cost of Health Care, by David Belk MD Medicare website 2020 Trustees Report on Medicare Medicare Advantage Wikipedia October – December 2020 Approved Medicare Supplement (Medigap) plan premiums (WA state) National Association of Insurance Commissioners -- 2018 Medicare Supplement Loss Ratios Comparing Medicare Supplement (Medigap) and Medicare Advantage plans State Averages for the 2020 Medicare Advantage Monthly Capitation Payments Medicare Advantage Plans Overbill Taxpayers By Billions Annually, Records Show Proportion of branded versus generic drug prescriptions dispensed in the United States from 2005 to 2019 Adding an Out-of-Pocket Spending Limit to Traditional Medicare, Urban Institute (June, 6 2022) Capping Medicare Beneficiary Part D Spending at $2,000, Urban Institute (March 2022) |
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