Year End Insurance Planning for Seniors with Diabetes

Disclaimer: This article provides general insurance planning guidance, including helpful tips for year-end insurance planning. Always consult with your healthcare provider and insurance representative for personalized advice.

As the year draws to a close, it’s time for smart year end insurance planning to ensure you’re making the most of your Medicare coverage and diabetes management benefits. This comprehensive guide will help you review your insurance needs, understand upcoming changes, and prepare for the year ahead.

Why Year-End Insurance Planning Matters for Seniors with Diabetes

Managing diabetes requires consistent access to supplies, medications, and healthcare services. Proper insurance planning helps you:

• Avoid gaps in coverage for CGM supplies and insulin
• Maximize your Medicare benefits before they reset
• Plan for any upcoming changes in coverage or costs
• Prepare for the new year’s deductibles and out-of-pocket maximums
• Take advantage of remaining benefits before they expire

📅 Mark your calendar: Start your year end insurance planning by October to allow time for any necessary changes during Medicare Open Enrollment (October 15 – December 7).

Your Year End Insurance Planning Checklist

Follow these steps to review and optimize your coverage:

1. Review Your Current Coverage

Take inventory of all your insurance policies:

Medicare Coverage:

• ✅ Medicare Part B coverage for CGM and supplies
• ✅ Prescription drug coverage (Part D)
• ✅ Medicare Advantage or Supplement plans
• ✅ Any secondary insurance policies

Document These Details:

• Policy numbers and group IDs
• Premium amounts and payment methods
• Deductible status (met or remaining)
• Out-of-pocket maximum progress
• Copayment amounts for supplies

2. Evaluate This Year’s Healthcare Expenses

Gather records of your out-of-pocket costs for:

Diabetes Supplies:

• CGM supplies and sensors
• Test strips and lancets
• Insulin pumps and supplies
• Glucose tablets and glucagon kits

Medications:

• Insulin costs
• Oral diabetes medications
• Other prescription drugs
• Over-the-counter supplies

Medical Services:

• Doctor visits and specialist consultations
• Lab tests and A1C checks
• Emergency care or hospitalizations
• Preventive services

💡 Pro Tip: Keep all your medical receipts in one place. These help track expenses and may be useful for tax deductions.

Understanding Medicare Changes for 2025

Stay informed about updates that could affect your coverage:

Key Updates Include:

• New Medicare Part B premium rates (typically announced in November)
• Changes to deductibles and copayments
• Updated coverage criteria for diabetes supplies
• Expanded telehealth benefits continuing post-pandemic
• New medications added to formularies

Important: Medicare coverage for CGM systems continues to expand. Check if you qualify for additional benefits under new guidelines.

Medicare Open Enrollment Action Plan

October 15 – December 7: Your Window for Changes

Week 1-2: Research Phase

• Review your Annual Notice of Change (ANOC)
• Compare current plan with alternatives
• Check if your doctors remain in-network
• Verify your medications are still covered

Week 3-4: Decision Phase

• Use Medicare Plan Finder at Medicare.gov
• Calculate total expected costs for next year
• Consider convenience factors (pharmacy networks, mail order)
• Review star ratings for plan quality

Week 5-6: Enrollment Phase

• Make your selection online, by phone, or with help
• Print confirmation for your records
• Mark calendar for January 1 effective date
• Notify providers of any changes

Maximizing Current Year Benefits

Use It or Lose It Benefits:

Before December 31, take advantage of:

Preventive Services:

• Annual wellness visit
• Diabetic eye exam
• Foot exams (2 per year for diabetics)
• Cardiovascular screenings
• Flu and pneumonia vaccines

Supplies to Stock:

• Order 90-day supplies of medications
• Get maximum allowed CGM sensors
• Replace any worn equipment
• Update glucose meter if needed

FSA/HSA Funds:

• Spend remaining Flexible Spending Account balances
• Stock up on eligible supplies
• Get new prescription glasses
• Schedule dental work

Planning for 2025 Deductibles

Financial Preparation Steps:

1. Calculate Expected Costs:
   • Part B deductible (check 2025 amount)
   • Part D deductible (if applicable)
   • Expected copayments for January
2. Budget Strategies:
   • Set aside funds for January expenses
   • Consider payment plans if available
   • Review supplemental insurance options
   • Check for assistance programs
3. Timing Considerations:
   • Schedule non-urgent procedures strategically
   • Plan for when deductibles reset
   • Consider generic alternatives in January

Special Considerations for CGM Users

Year-End CGM Planning:

• Verify 2025 coverage requirements
• Stock up on sensors before year end
• Update prescriptions if expiring
• Confirm your DME supplier for next year
• Check if prior authorization needs renewal

Documentation Needed:

• Recent A1C results
• Doctor’s orders for CGM
• Usage compliance data
• Medical necessity letters

Tax Planning for Medical Expenses

Deductible Medical Expenses:

Track these costs for potential tax deductions:

Qualifying Expenses:

• Medicare premiums (Part B, D, Medigap)
• Out-of-pocket medical costs
• Prescription medications
• Medical equipment and supplies
• Travel for medical care

Organization Tips:

• Create expense categories
• Save digital copies of receipts
• Use expense tracking apps
• Consult tax professional

Common Year-End Mistakes to Avoid

1. Waiting too long to review coverage
2. Not comparing plan options annually
3. Forgetting to use FSA funds
4. Missing enrollment deadlines
5. Not updating beneficiary information
6. Ignoring plan change notices
7. Failing to coordinate spousal benefits

Creating Your 2025 Healthcare Strategy

Monthly Planning Calendar:

January:

• New coverage begins
• Meet new deductibles
• Update provider information

February:

• Review first EOBs
• Confirm coverage working properly

March:

• Schedule annual appointments
• Update prescription refills

Quarterly:

• Review spending against budget
• Track progress toward out-of-pocket max
• Adjust medication timing if needed

Resources for Insurance Planning

Helpful Tools:

• Medicare.gov Plan Finder – Compare all options
• MyMedicare.gov – Access your personal information
• 1-800-MEDICARE – Speak with counselors
• SHIP (State Health Insurance Program) – Free local counseling
• Medicare Rights Center – Independent guidance

Documents to Gather:

• Current insurance cards
• List of medications
• Provider contact information
• Previous year’s medical expenses
• Income information for subsidy programs

Getting Professional Help

Consider assistance from:

• SHIP counselors (free service)
• Medicare brokers (no cost to you)
• Financial planners specializing in healthcare
• Patient advocates at hospitals
• Diabetes educators for supply planning

Action Steps for This Week

1. Locate all insurance documents
2. Create expense spreadsheet
3. Schedule medication refills
4. Review Medicare mail carefully
5. Mark important dates on calendar

The Bottom Line

Effective year end insurance planning ensures continuous access to your diabetes supplies and medications while maximizing your benefits and minimizing costs. Don’t wait until December – start your planning now for a smooth transition into the new year.

References

• American Diabetes Association
• CDC – Diabetes
• NIH/NIDDK – Diabetes Information
• National Institute on Aging – Diabetes in Older People

Need Help Navigating Your Coverage?

Senior CGM Support’s insurance specialists understand the complexities of Medicare coverage for diabetes supplies. We can help you:

• Understand your CGM coverage options
• Navigate prior authorizations
• Maximize your benefits
• Plan for next year’s needs

Call Now: 727-831-3729

Let our experts guide you through your year-end planning