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New Update: Healthcare Costs Increasing by Over 60% in Some States. Will you be impacted?

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Navigating Rising Medicare Costs: A Eli Lilly Employee’s Guide

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Healthcare Provider Update: Eli Lilly's primary healthcare provider initiatives are often tied to their pharmaceutical products and drug distribution networks, which include partnerships with a variety of healthcare systems and organizations to ensure that patients have access to their medications and therapies. Looking ahead to 2026, the healthcare landscape is expected to witness significant cost increases, particularly in health insurance premiums for Affordable Care Act (ACA) marketplace plans. With some states projecting hikes exceeding 60%, many individuals could see their out-of-pocket costs soar by over 75% if enhanced federal premium subsidies are not extended. This surge is driven by a combination of rising medical costs, including both hospital and prescription drug expenses, and the profitability pressures on insurers, prompting them to request substantial rate increases. As a result, consumers, especially those relying on ACA coverage, might face unprecedented financial strain in their quest for adequate healthcare. Click here to learn more

“In light of projected Medicare Part B premium increases, Eli Lilly employees should proactively adjust their retirement income projections and consult with a financial advisor to address rising health care expenses.” – Michael Corgiat, a representative of The Retirement Group, a division of Wealth Enhancement.

“In anticipation of significant Medicare Part B premium hikes, Eli Lilly employees would benefit from integrating health care cost projections into their retirement plans and seeking guidance from professional advisors on potential relief strategies.” – Brent Wolf, a representative of The Retirement Group, a division of Wealth Enhancement.

In this article we will discuss:

  1. The upcoming Medicare Part B premium increase and its impact on retirement budgets.

  2. How Medicare Part B is funded and how COLA adjustments compare to premium hikes.

  3. Strategic planning tips to help Eli Lilly retirees manage rising health care costs.

There will soon be a significant shift in Medicare expenses that could affect your retirement budget. According to the 2025 Medicare Trustees Report, the average Part B premium will jump by 11.6%—rising from $185 in 2025 to $206.50 in 2026 1 —outpacing most Social Security cost of living adjustments (COLA) over the last decade. Eli Lilly employees should begin factoring this increase into their long-term financial plans.

Benefit Structure for Medicare Part B

Outpatient and preventative care are covered under Part B, including:

  • - Cancer screenings, diagnostic procedures, and doctor visits

  • - Durable medical equipment and mental health counseling

  • - Prescription medications for outpatients and ambulance transportation

  • - Skilled nursing services and home health care

In 2025, beneficiaries must pay a $185 monthly premium, a $257 annual deductible, and a 20% co-insurance on most services—important information for any Eli Lilly retiree’s annual budget.

History of Premiums (2015–2025)

Year Standard Premium Dollar Change Percentage Change
2015
2016 $121.80 +$16.90 16.1%
2017 $134.00 +$12.20 10.0%
2018 $134.00 +$0.00 0.0%
2019 $135.50 +$1.50 1.1%
2020 $144.60 +$9.10 6.7%
2021 $148.50 +$3.90 2.7%
2022 $170.10 +$21.60 14.5%
2023 $164.90 –$5.20 –3.1%
2024 $174.70 +$9.80 5.9%
2025 $185.00 +$10.30 5.9%

The 2022 increase—a 14.5% rise driven by higher drug costs and pandemic-related utilization—served as a warning sign that’s echoed in the projected 2026 jump.

Estimated Premiums (2026–2034)

Year Estimated Premium Dollar Growth Percentage Growth
2026 $206.50 +$21.50 11.6%
2027 $218.60 +$12.10 5.9%
2028 $231.30 +$12.70 5.9%
2029 $247.40 +$16.10 5.8%
2030 $264.70 +$17.30 7.0%
2031 $281.60 +$16.90 6.4%
2032 $300.80 +$19.20 6.8%
2033 $325.90 +$25.10 7.0%
2034 $347.50 +$21.60 6.6%

Part B premiums alone could approach $350 per month by 2034—a 231% increase since 2015—underscoring why Eli Lilly retirees should plan now to mitigate long-term budget shocks.

The Funding Mechanisms

There are two primary sources of funding for Medicare Part B:

1. 75% from general U.S. Treasury revenues

2. 25% from premiums paid by beneficiaries

Premium income reached $139.8 billion in 2024, 2  with additional support from brand name drug fees and trust fund interest—details that Eli Lilly retirees may find crucial when reviewing their future health care funding.

Cost of Living Adjustments vs. Premium Increases

In 2026, the “hold harmless” provision that protects most Social Security benefits from Part B hikes may not apply. The anticipated 2.5% Social Security COLA—roughly $50 per month—still falls short of the $21.50 premium increase. Only recipients with monthly benefits under $800 will see any net gain, so Eli Lilly employees relying on Social Security should plan for most of their increase to be offset.

Strategic Planning Tips

To manage rising health care costs, Eli Lilly employees should consider the following proactive steps:

  • Forecast Health Care Inflation:  Incorporate rising out-of-pocket costs and premiums into your annual budgeting.

  • Compare Plans Online:  Use the official Medicare Plan Finder to evaluate alternatives beyond agent recommendations.

  • Manage IRMAA Exposures:  Employ tax-sensitive strategies—such as income smoothing withdrawals—to help limit future surcharges.

  • Explore Local Tax Relief:  Research state and municipal programs offering property tax exemptions or rebates for seniors.

  • Stress-Test Your Retirement Portfolio:  Model health care inflation scenarios over multiple decades and adjust allocations to safeguard purchasing power.

Extended Consequences

By 2034, annual Part B costs alone could top $3,000–$4,000 if current trends persist—one of the fastest rising expense categories for retirement households. Eli Lilly retirees who plan early can navigate budgetary shocks to help maintain their lifestyle goals.

According to Wealth Enhancement’s Patrick Ray, this premium surge ranks among the steepest retirement cost increases, and prudent investors must factor health care inflation into their retirement forecasts to mitigate unwelcome surprises.

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Sources:

1. USA Today. ' Social Security 2026 COLA estimated at 2.7%, but much of it will go to Medicare Part B ,' by Medora Lee. 17 July 2025.

2. Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds. ' 2025 Annual Report of the Boards of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds ,' U.S. Department of Health and Human Services, 18 June 2025. 

Other Resources:

1. Kaiser Family Foundation. “ FAQs on Medicare Financing and Trust Fund Solvency .” Kaiser Family Foundation, 15 June 2024.

3. Urban Institute. “ Applying a Premium Cap in Medicare Part B and Part D .” Urban Institute, Mar. 2023.

4. “ Social Security’s 2026 COLA: Recipients Could Get More Money Next Year .” LiveNOW from FOX, 15 June 2025.

5. Kiplinger Staff. “ Medicare Premiums 2026: Projected IRMAA Brackets and Surcharges for Parts B and D .” Kiplinger, 26 June 2025.

What is the 401(k) plan offered by Eli Lilly?

The 401(k) plan at Eli Lilly is a retirement savings plan that allows employees to save a portion of their salary on a tax-deferred basis.

How does Eli Lilly match employee contributions to the 401(k) plan?

Eli Lilly offers a matching contribution up to a certain percentage of the employee's salary, which helps to boost retirement savings.

Can employees at Eli Lilly choose how their 401(k) contributions are invested?

Yes, employees at Eli Lilly can select from a variety of investment options for their 401(k) contributions, including stocks, bonds, and mutual funds.

What is the eligibility requirement for Eli Lilly's 401(k) plan?

Employees at Eli Lilly are typically eligible to participate in the 401(k) plan after completing a specific period of employment, usually within the first year.

How can Eli Lilly employees enroll in the 401(k) plan?

Eli Lilly employees can enroll in the 401(k) plan through the company’s online benefits portal or by contacting the HR department for assistance.

What are the contribution limits for Eli Lilly's 401(k) plan?

The contribution limits for Eli Lilly's 401(k) plan are set according to IRS guidelines, which can change annually. Employees should refer to the latest IRS limits for specifics.

Does Eli Lilly offer a Roth 401(k) option?

Yes, Eli Lilly provides a Roth 401(k) option that allows employees to make after-tax contributions, which can grow tax-free.

What happens to my Eli Lilly 401(k) if I leave the company?

If you leave Eli Lilly, you have several options for your 401(k), including rolling it over to another retirement account, cashing it out, or leaving it in the Eli Lilly plan if allowed.

Are there any fees associated with Eli Lilly's 401(k) plan?

Yes, there may be administrative fees or investment-related fees associated with Eli Lilly's 401(k) plan, which are disclosed in the plan documents.

How often can I change my contribution amount to the Eli Lilly 401(k) plan?

Employees at Eli Lilly can typically change their contribution amounts at any time, subject to the plan's rules and guidelines.

With the current political climate we are in it is important to keep up with current news and remain knowledgeable about your benefits.
Eli Lilly offers comprehensive employee retirement benefits, including both pension plans and 401(k) plans. The Lilly Pension Plan is a Defined Benefit (DB) plan, where the pension is determined by an employee's earnings and years of service at the company. This pension plan has been updated over the years, with specific attention to tax and regulatory changes. Employees qualify based on their length of service and meet eligibility requirements outlined in Eli Lilly’s internal documents. The Lilly Pension Plan uses a final average pay formula to calculate the pension, meaning the pension is based on an employee's earnings during their final years of employment​ (SEC.gov). Eli Lilly also provides a 401(k) plan known as The Lilly Employee 401(k) Plan. This plan was established to help employees save for retirement, incorporating both employer contributions and employee savings. As of January 1, 2006, it was amended to include an Employee Stock Ownership Plan (ESOP) within the 401(k). Eligibility for the 401(k) plan includes all regular, full-time employees of Eli Lilly, as well as its subsidiaries and affiliates​ (SEC.gov). The company matches contributions and offers vesting schedules based on years of service. For instance, employees become fully vested after completing five years of service, as outlined in their official documentation​ (SEC.gov). The pension and 401(k) plan information for Eli Lilly has been extensively documented in their official filings with the SEC, where the detailed structure of the plans is outlined, including the qualifications for participation and vesting. Specific sections such as those covering mergers and eligibility requirements for different types of employees, including those under subsidiary plans, are found in their formal pension and 401(k) documentation​ (SEC.gov)​ (SEC.gov).
Restructuring and Layoffs: In 2023, Eli Lilly announced significant restructuring efforts, including the reduction of 3,500 jobs globally. This move is part of their strategy to save $500 million annually, with half of the savings aimed at product launches and R&D efforts. The layoffs are primarily focused on early retirement programs, site closures in New Jersey and Shanghai, and the consolidation of manufacturing locations​ (FiercePharma). This news is critical to address due to the current economic climate, where inflationary pressures and cost-cutting measures are widespread. The political environment also affects the pharmaceutical industry, making it crucial to track how companies like Eli Lilly adjust their workforce to stay competitive​ (FiercePharma).
Eli Lilly provides its employees with both stock options and Restricted Stock Units (RSUs) as part of its long-term incentive compensation. These RSUs are issued to employees and are subject to a vesting schedule, typically staggered over a period of time such as one, two, or three years. The goal is to retain employees by ensuring they receive full ownership of the stock only after they have fulfilled a specified period of service with the company​ (BusinessOwnerAdvisor). Stock options at Eli Lilly grant employees the opportunity to purchase company stock at a predetermined price, typically at the market value on the grant date. These options often vest over several years, with employees being able to exercise them once they are vested. RSUs, on the other hand, provide employees with company shares once they are fully vested, and these shares are taxed as ordinary income at the time of vesting. Employees are responsible for deciding whether to sell the shares immediately or hold onto them, which involves considering factors like tax implications and portfolio diversification​ (Eli Lilly and Company)​ (Eli Lilly and Company). RSUs and stock options at Eli Lilly are available to a broad group of employees, typically those in management and other key roles. The availability of these stock-based compensation forms reflects Eli Lilly's commitment to aligning employee incentives with company performance, and they play a crucial role in employee retention​ (BusinessOwnerAdvisor).
Eli Lilly has been making significant strides in its healthcare offerings, particularly through the launch of its digital platform, LillyDirect. This platform focuses on providing support for patients with chronic illnesses such as obesity, diabetes, and migraines. By enabling patients to access telehealth services and facilitating direct home delivery of certain medications, Eli Lilly has made healthcare more accessible and streamlined for patients dealing with these conditions. Additionally, LillyDirect offers educational resources and digital pharmacy solutions, making it easier for patients to refill prescriptions and receive medications at home. This initiative is crucial as it caters to a growing need for convenient healthcare, especially in light of the current economic pressures and the healthcare industry's shift towards digital solutions​ (PYMNTS.com)​ (PYMNTS.com). In the broader context of Eli Lilly's healthcare initiatives, the company's focus on digital healthcare aligns with current trends in healthcare delivery. The importance of platforms like LillyDirect is underscored by the economic and political pressures on the healthcare system, particularly as patients seek cost-effective and accessible treatments. Moreover, the growing political discourse around healthcare reform, coupled with tax implications for pharmaceutical benefits, further highlights the relevance of Lilly's approach. By offering services such as telehealth and home delivery, Eli Lilly is positioning itself at the forefront of healthcare innovation, which is critical for ensuring patient satisfaction in a competitive market​ (PYMNTS.com)​ (HealthCare ME&A Magazine).
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For more information you can reach the plan administrator for Eli Lilly at Lilly Corporate Center Indianapolis, IN 46285; or by calling them at (317) 276-2000.

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