A problem delayed but not averted with Medicare Part D

Millions of people who are eligible for Medicare, but are still working past age 65, just dodged a bullet.

The new $2,000 cap on out-of-pocket Medicare Part D spending will have some unintended consequences. One will impact millions of people still working past age 65 with creditable coverage through their employer.

Creditable Coverage means that your drug coverage plan through your work insurance is “as good or better” than what Medicare Part D offers. Since most employer health plans lump the maximum you can spend on your medications in a year together with your other health costs, the government has kicked this can down the road. While this could have created a crisis for people with work insurance this year, it won’t. But eventually, the government either changes the rules again or every employer group health plan will have to break out your maximum costs for medications. If the amount is over $2,000 your plan may not meet the creditable coverage guidelines.

When you are age 65 or older and do not have creditable coverage, you’ll face a Medicare Part D late penalty. Be aware this is a pending issue for those working past age 65, but will not cause a problem in 2025.

Sylvia Gordon is known as Medicare Mama on social media. She and the Noblesville-based TheMedicareFamily.com have amassed nearly one million followers online where she teaches about Medicare, Social Security, and retirement.