When it comes to Medicare Open Enrollment this year (October 15 to December 7) there's good news and bad news for older adults. The good news is that for the first time ever, thanks to Congress passing a new prescription drug law in 2022, out-of-pocket drug costs will be capped at $2000 annually AND you can pay that in monthly installments. This is HUGE for anyone who has had to pay thousands for their needed prescription drugs.

In addition, the new law limits insulin costs to $35 a month and gives Medicare the power to negotiate with drug makers to lower prices. In the first round of negotiations, which is expected to involve 10 popular drugs available at reduced cost in 2026, Medicare beneficiaries are expected to save as much as $1.5 billion in out-of-pocket expenses.

However, the bad news is that insurance companies are responding to the changes by trimming and/or cutting benefits and increasing charges elsewhere, which could prove costly (and complicated) for Medicare beneficiaries.

“This year’s Medicare marketplace will be more chaotic than ever,” said Vijay Kotte, chief executive of Medicare marketplace GoHealth, told USAToday. “With fewer options, higher costs, and diminished benefits, older adults will be forced to navigate one of the most disruptive enrollment seasons in recent memory.”

Local experts agree. "There are a lot of moving parts this year, so it’s more important than ever before to look at your options during open enrollment," says Randy Rodgers, who manages JABA's Insurance Counseling program.

Indeed, Rogers, JABA CEO Marta Keane, and representatives from the UVA Health System had a round-table discussion earlier this year with one of the lawmakers who helped pass the new law and voiced their concerns. The lawmaker took notice.

“Overwhelmingly, what I hear is, ‘Thanks for the reductions in prescription drug price, but it’s still too complicated,’” Virginia Senator Tim Kaine later told The Daily Progress. “There’s a lot of deceptive, or at least confusing, marketing that comes to seniors when they’re about to become Social Security-eligible, and that leads people to choose plans that aren’t the best plans for themselves. So there’s a heavy kind of consumer protection theme to this conversation that I’m going to take back with me.”

Fortunately, Medicare beneficiaries in our area, and those new to Medicare, have JABA's Insurance Counseling program to turn to for free, unbiased, confidential counseling and assistance for people with Medicare. They are part of The Virginia Insurance Counseling and Assistance Program (VICAP), which itself is part of a national network of programs that help people understand Medicare. Virginia Senior Medicare Patrol (Virginia SMP) also helps Medicare beneficiaries avoid healthcare fraud and abuse.

"Last year we helped over two thousand people during Medicare open enrollment," says Rogers, "...and fifty percent of those people changed plans because they were going to save money on their premiums or prescriptions. Throughout open enrollment last year we helped people save nearly two million on their prescriptions. So, it's important to look at your options during open enrollment."

David McNair handles communications, media relations, and social media efforts for JABA. This article orginially appeared in C-Ville Weekly.