Anson Blue Cross- Medicare prescription drug deductible to increase by nearly $45 next year_1

At the Senior Health Expo held on October 26, Xiao Liyang, the Chinese Market Sales Manager for Anthem Blue Cross, shared important updates regarding significant changes to federal Medicare benefits set to take effect in 2025.

The annual enrollment period for Medicare, which caters to seniors aged 65 and over, began on the day of the expo and will continue until December 7. During this period, beneficiaries can adjust their current Medicare plans, with new coverage starting on January 1, 2025. Xiao emphasized that the year 2025 will bring substantial modifications to Medicare—informally known as “Red, White, and Blue” cards—especially regarding prescription drug coverage, which will greatly impact older adults.

He noted that starting in 2025, the annual out-of-pocket maximum for prescription drugs will increase from the current $545 to $590—a rise of nearly $45. Another critical change is the elimination of the “donut hole,” which will lower the annual out-of-pocket limit. Seniors will only need to pay up to $2,000 for covered medications each year before their out-of-pocket costs are capped. This reform is beneficial for patients who require expensive medications, as they will be capped at a maximum of $2,000, with actual expenses likely being lower. However, those who do not rely heavily on medications may face higher drug costs.

For insurance companies, overall costs are projected to double next year. Previously, 1% of members consumed 15% of resources, but that figure is expected to rise to as much as 30%. With more people entering the catastrophic coverage tier, insurance companies will see costs triple, as the government shifts financial burdens onto insurers and pharmaceutical companies, which will ultimately be passed on to consumers.

In response, Anthem Blue Cross plans to move high-cost medications from tiers three and four into lower-cost categories to help members save on their drug expenses. They will also provide various educational programs to enhance transparency and ensure members are well-informed about their options.

Among the 20 most commonly prescribed medications, the majority offered by Anthem Blue Cross in 2025 will fall into the first and second tiers, which are generally more affordable. Xiao urged beneficiaries to review the annual notices regarding medication coverage changes from their insurance companies. This crucial document outlines current benefits and the differences for the upcoming year, encouraging members to consult with their insurance agents for comparisons.