Part D Senior Savings Model is set for a big change starting in January 2023. Due to the Inflation Reduction Act, there will be a cost-sharing cap for each insulin product that is covered under a Medicare prescription drug plan to $35 for a month’s supply. Changes also include prescription drug deductibles no longer applying to covered insulin products and a special election period starting from December 8th-December 31st 2023 for all insulin users to switch through 1-800-Medicare.
2023 Part D Senior Savings Model
The Part D Senior Savings Model was first introduced in January 2021 by CMS (Centers for Medicare & Medicaid Services). The model was designed to provide Medicare beneficiaries new choices of Prescription drug plans that offer insulin at an affordable and predictable cost where a monthly supply of a broad set of plan-formulary insulins won’t exceed more than $35 each.
Impact on Medicare Agents
One in every three Medicare beneficiaries suffers from diabetes and over 3 million Medicare beneficiaries utilize common forms of insulin. The Part D Senior Savings Model, along with the increase in social security and reduction in Part B premiums, potentially gives more money into the client’s pockets. This allows insurance agents to help cover gaps in their coverage, whether that be a hospital indemnity or something like a lump-sum cancer policy, that could have a drastic impact on the client being able to protect themselves against unfortunate medical events.
While not all insurance companies have come out with their stance on AOR (Agent of Record) changes due to the insulin SEP, shout out to United Healthcare for saying they will protect original agents of record. This is for any client that changes from one United Healthcare MA product to another United Healthcare MA product even though it’s through 1-800-Medicare.
Where does Pinnacle Financial Services come in?
Pinnacle Financial Services is a full-service “FMO” that is dedicated to helping agents across the country both grow and retain their book of business. We have a dedicated sales support team, the best training in the industry, and technology second to none. It’s not too late to sell during AEP. Call us today!
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1 (800) 772-6881 x7731 | sales@pfsinsurance.com
Rob Valincius
Director of Agent Training
Contact a Pinnacle Representative if you have any questions.
1 (800) 772-6881
support@pfsinsurance.com
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