Are you ready for all the changes coming to Medicare?

WARREN, Ohio (WKBN) – Some of the biggest changes in years are happening right now with Medicare and if you are a recipient, you need to be ready.

The experts at TLC Insurance Group in Warren are ready to answer your questions and steer you the right way on your Medicare journey.

“Huge changes coming here in 2025. The Inflation Reduction Act. The biggest changes of inflation reduction that are happening right now, and what seniors and people on Medicare need to understand is that those changes are going to drastically impact all prescriptions,” said Craig Villwock, Co-owner of TLC Insurance Group. “And because of those big changes, what is occurring is that a lot of the shift of the actual cost-sharing that’s being paid–that was once paid by Medicare–is now being pushed onto the insurance carriers themselves.”

So what’s the most important thing people need to know?

“People need to get a review more than ever. Every single plan is changing this year,” said Villwock. “They need a good review this year and make sure they’re on the right plan going forward. They may not know what they don’t know.”

Some of the changes are causing insurance companies to make some tough decisions that are going to affect Medicare recipients.

“We’re a national marketing association, so we’re at the very top level of all the Medicare companies in the country. And what we’re seeing and what’s been described are some of the changes that they’re having to make because of the Inflation Reduction Act,” said Villwock. “The Inflation Reduction Act really only changes the way prescriptions are looked at for Medicare.”

Some of those changes include the shifting of responsibility of who’s paying for what and altering the entire look of Medicare itself and all the plans.

“So what basically is occurring is there is a shift from 2024 to 2025 on the responsibility of who’s paying for prescriptions. A lot of what was a lot paid for by the government itself is now being shifted to the insurance carriers of Medicare,” said Villwock. “The insurance carriers are now looking at a much higher out-of-pocket on their end. We’ve seen premiums raised on plans. We’ve seen some insurance carriers actually terminate plans altogether and basically force retirees on Medicare to find their own plans. We’ve also seen more co-insurance, more co-pays, higher deductibles.”

Some carriers have been forced to take away from other benefits on certain plans like dental and vision.

“We’ve seen some complete takeaways on that side as well. In the 25 years I’ve been in Medicare, we’ve never seen so much change. And it’s all caused because of the Inflation Reduction Act,” said Villwock. “What we’re suggesting to everybody is to get a review, because what you don’t know, you may not know and it may affect all kinds of parts of your plan, whether you’re on a Medicare prescription drug plan.”

Whether you’re on a Medicare Advantage Plan that includes prescription drugs and hospitals and doctors among other things, or whether you’re on a group plan, you need to review your plan to make sure you’re on the best one going forward into next year.

“That’s one of the things we offer. We’re a national broker and so we have all the companies locally and most of them nationally as well,” said Villwock. “We’re able to sit down with a retiree, look through their prescriptions, their needs overall in the health care, and help them figure out which plan might be best for them for 2020, because no two plans are the same.”

The most important thing to understand is that ALL plans are changing this year regardless of the plan you have. Villwock says it is imperative to get a review from October 15 to December 7 which is the annual open enrollment period. Otherwise, you could be stuck.

“We’ve literally seen everything affected. The benefits that they enjoyed in 2024–they may not know they’re not going to be there in 2025. We’ve seen higher co-pays. We’ve seen higher premiums. We’ve seen plans eliminated,” he said. “So people need to review to make sure they’re on the right plan for 2025. That’s the main thing we want to get across, is don’t take it for granted.”

The insurance groups has also seen husbands and wives going on different plans because of the prescriptions they are on and because of the drastic change that’s happening across the landscape of Medicare prescriptions.

“It’s changed a little bit of everything and the insurance carriers have had to make a lot of changes to compensate for those for those big significant changes,” said Villwock. We’re educating families and saying ‘Here’s what’s coming with the prescription changes in 2025,’ mostly due to the Inflation Reduction Act. That does include prescription changes. Well, guess what? These changes are not over for the prescriptions and the Inflation Reduction Act. There’s more changes coming in 2027 and more coming in 2030 as well.”

The bottom line? Medicare recipients need to be ready.

“People on Medicare just need to be ready and we’re willing and able to help them whenever they need. No cost, and no obligation for our service,” said Villwock. “There’s no charge. It’s a free consultation.”

TLC Insurance Group is located at 8775 East Market Street in Warren. Call (800)719-3751 and visit them online at TLCInsuranceGroup.com. You can also follow them on Facebook.

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