New Medicare Rule May Impact You (And Your Wallet)
Header Picture New Medicare Rule May Impact You (And Your Wallet)

If you or your parents are over 65, still working, and relying on employer health insurance, a new Medicare rule could significantly impact your prescription drug coverage and costs.

Currently, seniors can avoid late penalties for Medicare Part D (prescription drug coverage) if their employer’s plan offers similar coverage to traditional Medicare drug plans.

A recent change under the Inflation Reduction Act could have major consequences for seniors who delay Medicare enrollment.

Due to new “improved” Part D coverage, with a $2,000 out-of-pocket maximum, many employer plans may no longer be deemed equivalent and therefore will no longer qualify.

  • Seniors working past age 65
Those relying on employer health insurance
Employees with employer plans exceeding the $2,000 out-of-pocket maximum

While some parts of the Inflation Reduction Act have already been implemented, the $2,000 out-of-pocket maximum and its impact on employer-sponsored health insurance for Medicare-eligible individuals will take effect on January 1, 2025.

This means that as of the beginning of next year, employer plans must meet new, stricter standards to be considered creditable coverage and exempt seniors from Medicare Part D late enrollment penalties.

It's important to note that it might take some time for the full implications to become apparent.

We’ll also be on the lookout for any additional adjustments that may be made to the Inflation Adjustment Act regarding this and how employer-sponsored plans may respond before year-end.

If your employer plan no longer qualifies, you may face a late enrollment penalty when you eventually enroll in Medicare Part D. This penalty may significantly increase your monthly premium.

Contact your employer. Inquire about the status of your plan after the changes.
Research Medicare options. Understand your enrollment periods and available plans.

Remember, early planning is crucial for protecting your health and financial well-being in retirement.

Even if you’re not 65 and working, maybe your parents are. Make sure to forward this email along to them or anyone impacted.

We’re here to help you navigate the complexities of Medicare.

Simply reply to this email so we can examine how these changes may affect you, your family, and your financial plan.


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Christopher Conner, CEPA®, CFP®
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Adam Tirapelle, MBA, CIMA®
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Private Wealth Advisor
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https://www.hhs.gov/inflation-reduction-act/index.html#:~:text=President%20Biden's%20prescription%20drug%20law,strengthening%20Medicare%20for%20the
%20future
https://www.newsweek.com/new-medicare-rule-could-force-seniors-switch-health-insurance-1928581
https://www.medicare.gov/drug-coverage-part-d/what-medicare-part-d-drug-plans-cover
https://www.medicare.gov/basics/get-started-with-medicare/medicare-basics/working-past-65

Investment advice offered through Integrated Partners, a registered investment advisor, doing business as GC Wealth Advisors and its investment advisor representatives, Christopher Conner, Jason Rankin, Adam Tirapelle, and Kyle Trippel.

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