As of January 1, Medicare Part D offers major new benefits.
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Seniors have questions about Medicare
Posted
By Juan Proaño
As of January 1, Medicare Part D offers major new benefits. But whether seniors actually take full advantage of them remains an open question.
That's because some of the new benefits require seniors to opt-in -- and many seniors don't yet know about the changes to Medicare Part D. That's particularly true in the Latino community.
For many, of course, the primary barrier is language. Roughly two-thirds of Hispanic immigrants have limited English proficiency, which significantly impacts healthcare access and outcomes.
The language challenge is compounded by gaps in knowledge about how the healthcare system works. Many in our community struggle to navigate the red tape that isn't culturally tailored for them. A single misunderstood word can set someone on a false start that takes hours to correct.
These barriers to access don't exist in isolation. Older Latinos often rely on family caregivers, who may face the same language and cultural obstacles. In fact, 44% of Hispanic adults cite "more communication problems from language, cultural differences" as a major reason for the generally worse health of our communities.
So, what do Latino seniors and their families need to know about these changes to Medicare Part D in 2025? First, there's the new $2,000 per year cap on out-of-pocket expenses in Medicare's Part D prescription drug benefit. The cap applies to covered drugs regardless of how many medications you take or their cost. For example, if an abuela is already managing her chronic conditions with medications but her doctor orders another one, she should have no hesitation about filling it -- and doesn't need to give up any of those she is already taking.
The potential impact of these changes is substantial: Latino enrollees are projected to save an average of 33% in out-of-pocket costs in 2025, with some saving as much as $2,500 annually. For a community whose members often struggle to pay for healthcare alongside other necessities, these savings could be life-changing.
Equally important is the new Medicare Prescription Payment Plan. This voluntary program allows beneficiaries to spread their out-of-pocket costs evenly throughout the year, rather than facing high upfront costs at the pharmacy. Suppose, for example, you are taking an expensive medication and expect to hit the $2,000 cap by March. Instead of paying $1,000 in January and $1,000 in February, you can choose to pay about $167 each month for the entire year. This can be particularly beneficial for those on fixed incomes or those who struggle with large, unexpected expenses.
Seniors need to understand that while the $2,000 cap is automatic, the payment plan is not. Seniors must actively opt in, which they can do by phone, through a paper form, or via their plan's website.
Now imagine if every Latino-serving healthcare provider, community leader, and family became an ambassador for these changes. This grassroots approach, leveraging our tight-knit communities, could be the key to widespread adoption and improved health outcomes for our seniors.
Together, we can ensure that no one in our community gets left behind -- porque juntos, somos más fuertes. Because together, we're stronger.
Juan Proaño is the CEO of League of United Latin American Citizens (LULAC). This first appeared in RealClearHealth.