Puerto Rico Medicare beneficiaries have until Dec. 7 to update coverage
New pharmacy benefits will cap annual out-of-pocket costs at $2,000 starting in 2025.
The Centers for Medicare & Medicaid Services (CMS) in Puerto Rico are encouraging Medicare beneficiaries with either Medicare Advantage or Original Medicare with Part D coverage to review and update their health plans for 2025 by the Dec. 7 deadline.
Several changes to health plan coverages are being introduced for Medicare beneficiaries, including new pharmacy benefits that cap out-of-pocket spending at $2,000, the agency stated.
The open enrollment period offers beneficiaries an annual opportunity to evaluate their health plans and ensure that next year’s benefits meet their personal and medical needs.
“It is essential for beneficiaries to review their coverage to ensure they receive the services and benefits they need. This open enrollment period allows them to check and optimize their health plan for the coming year,” said Marina Díaz, director of the CMS Office in Puerto Rico and the U.S. Virgin Islands.
“The benefits of the new coverage they select will take effect on Jan. 1, 2025,” she added.
Starting in January, Medicare will introduce significant changes to pharmacy coverage. Beneficiaries with out-of-pocket drug expenses exceeding $2,000 can enroll in a voluntary payment plan, capping their annual medication costs at $2,000. Once a beneficiary reaches this limit, they will not have to pay for medications for the rest of the year.
This measure aims to help beneficiaries with high drug costs access necessary treatments without the financial burden of additional expenses after reaching the catastrophic coverage threshold, CMS explained.
“At CMS, we encourage all beneficiaries to consult with their health plans to understand the specifics of this new option and determine if it benefits them. It is important for each individual to have the information they need to make the most of their health coverage,” added Díaz.
