Medicare News Monday: Federal Funding Freeze/Reality Check

Photo Credit: France24

There was a lot of fear in the news last week with executive orders that threatened funding for many federal programs.  I know many of us were foggy on what was real and what was hearsay as the news came out rapid fire.  Some worried that they would lose their social security benefit and others were concerned they would no longer be able to pay for their desperately needed medications.  The anxiety was just overwhelming. Luckily a Hail Mary was thrown in the 11th hour and everything seemingly will remain the same for the foreseeable future. So what did all of that mean for Medicare?  

First I’d like to clarify that according to the Trump administration Medicare was never at risk for loss of funding.  This means that anyone under a special needs plan or anyone that qualifies for LIS was ever in danger of an interruption of their benefits. However what you might be wondering after that scare is, “What will I do if these benefits ever cease to exist?”  I don’t have a definite answer to that, but what I can tell you is that life will go on and there will be other ways to get the services that you still need.  No, I don’t have specifics but we aren’t over 2000 years into human civilization because Medicare has always been there.  

Knowing that should cause you to wonder what great benefits could you be missing out on by not understanding this great tool that our ancestors did have access to not even 60 years ago.  Pharmaceuticals have come far in the last quarter century and so has Medicare Part D.  As a matter of fact this year Part D insurance was completely transformed by dropping its ever confusion and frustration “Donut Hole”.  The coverage gap in previous years was what horror movies were made of.  Today, in 2025 it is no more.  

In previous years the way it worked was that both you and Medicare would reach a combined out of pocket cost of $5,050 (2024) before YOU would be responsible for more than just the copay cost of your medication, but now a percentage of the full cost of your medication.  Today however, 2025 Medicare has NO COVERAGE GAP.  This means that you will pay and total out of pocket cost (in the form of copays) of $2000.  After that max has been reached, your insurance plan will pay 100% of the cost of your medication for the rest of the year.  And suddenly, it feels like they care about us again. 

I feel like while we’re going into this next week with many unknowns, we can relax and believe that everything done will be for the greater good.  We can’t control the unknown, but we can educate ourselves as much as possible so that the unknown doesn’t catch us off guard.  If there are questions that you have about your Medicare plan, or about signing up for Medicare for the first time, do not hesitate to sign up for my Medicare Q and A set for Feb 23 2025,  I look forward to seeing you there!