Shop the coverage and rates that are right for you
Get Insurance Anywhere Logo
Get Insurance Anywhere Header
Request An Affordable Care Act Quote!
Call today for quotes
on health insurance
for Medicare beneficiaries
or any other type of
health or life insurance!
Medicare Beneficiaries:
877-734-3884 (TTY: 711)
All Other:
786-970-0740 (CELL)
Request An Affordable Care Act Quote!
Call today for quotes on health insurance for
or any other type of health or life insurance!

877-734-3884 (TTY: 711)

All Other:
786-970-0740 (CELL)


Medicare - February 2024




Visit our website
News & Updates For Medicare Beneficiaries

This month’s newsletter contains three different articles concerning prescription drugs.

The first article explains the changes that have been made to outpatient drug plans for 2024 and that are scheduled to be made in 2025 in accordance with the Inflation Reduction Act.

The second article explains what a pharmacy benefits manager is and explains what is meant by spread pricing.  There is bipartisan support in Congress to regulate the practices of pharmacy benefits managers, require more transparency in drug pricing, and eliminate or reduce the effects of spread pricing. It is probable that some legislation affecting pharmacy benefits managers will be part of any legislation passed to fund the government for the balance of FY 2024. We advise readers to understand the effect of changes that have been made to 2024 drug plans (see the first article of this newsletter) and to avoid buying any medications outside of their drug plan if they would otherwise meet the TrOOP threshold for 2024.

The third article appeared in the January 21 issue of USA Today and contains suggestions on finding less expensive medications.


Significant changes have been made to outpatient prescription drug plans (both Medicare Advantage Prescription Drug Plans and Stand-Alone Part D Plans) this year, and even more significant changes will be made next year.


The two most significant changes made this year are the elimination of copays and coinsurance once an individual hits the catastrophic phase of their drug plan and the liberalization of eligibility for low-income subsidies (extra help”) for those earning between 135% and 50% of the Federal Poverty Level.


In 2025 the coverage gap (aka “donut hole”) phase will be eliminated and copays/coinsurance paid during the initial coverage level will be paid until the beneficiariy’s out-of-pocket costs for covered medications reach $2,000. This number will be indexed starting in 2026. There will also be significant changes in Part D plan, manufacturers, and the government (i.e., Medicare) cost shares between 2024 and 2025. As a result of these changes, we expect significant plan design changes in 2025 and, possibly, premiums for 2025.


Learn more about these changes by clicking on these links:


What Changes To Drug Plans Have Been Made For 2024?

What Changes To Drug Plan Provisions Will be Made For 2025?


The following article appeared in the January 24 issue of Modern Healthcare.

The pharmacy benefit manager industry could look a lot different soon if Congress follows through with bipartisan efforts to pass bills governing the sector.


PBMs such as CVS Caremark, Express Scripts and OptumRx would face new transparency requirements that would give health insurance companies, employers, customers, and regulators new insights into how they negotiate prices for prescription medicines—and how much of the savings they generate find their way to patients and plan sponsors. Pending legislation also would prohibit lucrative practices such as spread pricing.

Related: Congress is taking aim at PBMs. Here's why and what happens next.

If Congress surmounts its protracted efforts to fund the federal government for the remainder of fiscal 2024 and to reauthorize key programs, a handful of PBM measures could see action in 2024. One bill, the Lower Costs, More Transparency Act of 2023, passed the House 320-71 last month.

Less than two years after Congress and President Joe Biden enacted policies targeting drugmakers, their attention to pharmaceutical prices has moved on to the PBM industry, which has played an increasingly large role in the healthcare system over the decades. CVS Health subsidiary CVS Caremark, Cigna subsidiary Express Scripts and UnitedHealth Group subsidiary OptumRx dominate the sector and are key examples of how consolidation and vertical integration have transformed the healthcare system.

Under the bills Congress is considering, PBMs would be required to disclose drug rebates and discounts and to scale back business practices, including spread pricing. This could diminish PBM profits and force companies to rethink how they generate value for clients.


Read the entire article here.


Read this article that appeared in the January 21 edition of USA Today for tips on finding less expensive medications. Before following any of these recommendations read the first article of this newsletter and make sure that using one of these methods does not adversely affect your ability to reach the catastrophic threshold in the event you are on a large number of medications or utilize one or more expensive medications and have a chance to reach the catastrophic threshold in 2024 and thereby qualify for zero cost medications under your drug plan for the balance of 2024.

About Paul Cholak

Paul is a licensed, independent health and life insurance agent and has over forty years of benefits experience and specializes in helping Medicare beneficiaries obtain health insurance. However, he offers a complete array of life and health insurance products to individuals of all ages.

He guides Medicare beneficiaries through the steps of getting insurance and is available to help clients both BEFORE and AFTER they've made their purchase decision.

Disclaimer for Part C and D plans: "We do not offer every plan available in your area.  Any information we provide is limited to those plans we do offer in your area.  Please contact or 1-800-MEDICARE (TTY: 1-877-2048) to get information on all your options."

Learn About The Services We Offer

Contact Us

Local: 561-734-3884 (TTY: 711)

Toll-free: 877-734-3884 (TTY:711)

Facebook  Linkedin  
Schedule For 2024
Affordable Care Act Enrollment

Affordable Care Act open enrollment for 2024 plans began November 1, 2023 and ended January 16, 2024 on the Federal Facilitated Marketplace (

You’re eligible to enroll ONLY if you have a Qualifying Life Event.
There are no pre-existing condition limitations.

Call Us At 786-970-0740 (Cell)
to determine what kind of plan you may be eligible for.

2024 Annual Enrollment Period For Medicare Eligibles

The Annual Enrollment Period for Medicare-eligibles that ran from October 15 through December 7, 2023 for a January 1, 2024 effective date has ended.

You’re eligible to enroll now ONLY if you’re first becoming eligible for Medicare or are eligible for another type of enrollment period. Enrollment rules differ between Medicare Supplement plans and Medicare Advantage, Medicare Advantage Prescription Drug, and separate Medicare drug coverage (Part D).

Call us at 877-734-3884 (TTY: 711) for details.

family consulting

We offer a comprehensive set of Affordable Care Act (“Obamacare”) plans

to individuals and families qualified to buy health (tax- and non-tax subsidized) insurance and dental/vision and/or hearing plans through the Federal marketplace (this is called buying “on-exchange” or “on-marketplace”) or directly from insurance carriers (this is referred to as buying “off-exchange or -marketplace”). Our Affordable Care Act policies comply with the Affordable Care Act and contain all of the “essential health benefits” required by that law.

The dental/vision and/or hearing insurance

products are available both on an insured or discount basis

We offer short-term health insurance policies

for those who are looking for more inexpensive coverage and shorter term alternatives.

We offer Medicare Supplement, Medicare Advantage, and Part D Drug plans

to Medicare-eligibles. Our site is compliant with federal, state, and carrier guidelines in selling these policies. See the Medicare-eligibles section of this site for details.

We represent many carriers that offer supplemental benefits

to both individuals and families and Medicare beneficiaries, and the site contains information about hospital indemnity, cancer, critical illness, gap, accident, and international medical insurance offered by many different carriers. This section of the site also contains valuable information and tools about lowering the cost of prescription medications. Call us if you want more information about or would like to enroll in one of these products.

We also offer Short- and Long-Term Disability products

and can also help you meet the costs of long-term care, nursing home, or short-term (recovery) care needs.

Finally, we have a complete array of Life, Final Expense, and Annuity products

and offer pre-need services in Florida, as we have both life insurance and pre-need licenses in that state.

You pay nothing for our services:

we’re paid directly from the carriers we represent, Premiums are NEVER EVER marked up to include paying us for our services: you pay the same whether you order directly from the carrier or the marketplace on your own or directly through us or from our site.

We ONLY offer alternatives that are suitable for you and for which we feel meet YOUR needs.
When or if we feel a product or service is not appropriate for you from either a cost or benefit point of view we will tell you so.

We’re fully compliant with privacy and security guidelines, have signed all required privacy and security agreements, have developed a privacy and security policy, and take extraordinary steps to safeguard your protected health and personal information.
In short, we’re experts in all aspects of health and life insurance and also have relationships with professionals who can help you with very specialized situations.

More choices
Lower rates!
Calculate your health Insurance cost!
Get Rates & Plans
Or call today!
877-734-3884 (TTY 711)