Thanks to the Beneficiary Enrollment Notification and Eligibility Simplification (BENES) Act, big changes were made to Medicare beginning in January 2023. Whether you are already enrolled in Medicare or you plan to enroll this year, these changes will affect you.
Here is an outline of some of the provisions of the BENES Act from the team at Slutsky Elder Law in Pennsylvania:
Previously, those who enrolled in Medicare during the general enrollment period or in the later months of their initial enrollment period would often have to wait months for their coverage to go into effect. Others who made enrollment mistakes due to misinformation from their employer or insurance company could also experience coverage delays. The BENES Act has corrected these issues. The Secretary of Health and Human Services will now have the authority to establish additional special enrollment periods that will allow beneficiaries to access their benefits without unnecessary delays. Enrollment will also be more flexible for those who have made honest enrollment mistakes, or who were unable to enroll on time due to unusual circumstances like natural disasters or incarceration.
Changes to Medicare Part D Prescription Drug Benefits
The 2023 changes to Medicare incorporate some provisions from the Inflation Reduction Act that apply to prescription drug prices for Medicare recipients. Copays for patients who receive insulin will now be limited to $35 per month, per prescription, and out-of-pocket costs for most vaccines will be eliminated.
Some provisions of the Inflation Reduction Act will not be implemented until later years. In 2024, low-income assistance will be expanded for people with income below 150% of the federal poverty level. In 2025, a $2,000 annual cap will be imposed on out-of-pocket spending for prescription drugs. Part D enrollees will have the choice to pay this amount all at once, or in monthly installments. Drug price negotiations in 2025 are also expected to reduce the cost of the most expensive prescription drugs.
The Senate has also introduced the BENES 2.0 Act, which is intended to make further beneficial changes to Medicare. This would include requiring the government to distribute clear, unbiased, actionable information about the choices a person will have to make regarding Medicare at the age of 65 or after 24 months of receiving Social Security Disability Insurance. Although this bill has not yet been passed, it does enjoy the same bipartisan support as the original BENES Act, making its eventual passage very likely.
Elder Law Planning Attorney in Pennsylvania
Robert Slutsky has spent decades dedicating his life to the law-specific legal concerns of older Americans. If you need advice about Medicare and Medicaid planning or you are looking for estate planning lawyers in Lansdale, PA, or anywhere nearby, Slutsky Elder Law can help you. Whether you need a will, want to designate powers of attorney, or have been named as the executor of an estate, Rob can give you the right advice for your situation. Call (610) 940-0650 or fill out the form on our contact page to request a consultation with a knowledgeable elder law attorney today.