BUSINESS PROFILE: Breitenfeldt Group
Good news: $2,000 cap
Bad news: $2,000 cap
By Jim Palmer
Dennis Breitenfeldt, founder of Breitenfeldt Group, encourages all those on Medicare to pay close attention to their prescription drug coverage during open enrollment this fall.
Back in 2023, a new prescription drug law went into effect with the purpose of improving the Medicare program. It started by providing those with Part D access to more vaccines at no extra cost and a cap of $35/month for covered insulin. In 2024, the law was expanded to include the elimination of paying copays or coinsurance in the catastrophic phase of coverage. Now in 2025, this law will cap yearly Part D out-of-pocket costs at $2,000.
“This cap on drug spending is new to Medicare,” said Breitenfeldt. “The bad news is we’re seeing many stand-alone Part D plans either completely disappear from the market or increase in premium. The good news is that we have been keeping a close eye on these changes and are ready to assist you.”
When Breitenfeldt first started in the Medicare business almost 30 years ago, coverage for prescriptions simply did not exist. “The most common prescriptions for blood pressure, diabetes, and cholesterol would cost $100 to 200 per month and generics were not widely available,” said Breitenfeldt. “Back then we would help individuals find solutions through the VA, mail order, and low-income programs. If there was anything out there to help bring the cost down, we would look for it.”
Starting in 2025, Breitenfeldt said the good news is there will be a $2,000 cap for out-of-pocket spending on prescriptions and for those on expensive medications, this will be beneficial. The bad news is that someone has to pay for it…
“When a cap on drugs is implemented, the costs don’t just disappear,” said Breitenfeldt. “Insurance companies are now responsible for more of the cost, and we are seeing that cost passed on to those on a stand-alone Part D plan through increased premiums, formulary changes, and higher copays.”
According to Breitenfeldt, “some plans will remain, some will be discontinued, and some will change to being non-commissionable, meaning less agents out there are going to be willing to help with prescription coverage.”
That’s not the case with Breitenfeldt Group, according to Breitenfeldt. Their advisors are non-commissioned so they can truly focus on your goals. “If we change you to a new plan in the fall, it is for your benefit, not ours. And if we cannot assist, we will provide a trusted resource to guide you,” he said.
Knowing which plan is right for you is Breitenfeldt Group’s specialty. Their team can help compare premiums, benefits, provider choices, prescription drug coverage, and pharmacy options to make sure those they work with are on a plan that meets their needs based on their specific situation.
“Beyond helping you find a plan, we’re here to provide comfort, confidence, and certainty to all our clients,” he said.
And Breitenfeldt Group has been providing these things for Minnesotans (and beyond) for almost 30 years -- and all over the state those on Medicare have been singing their praises, according to Breitenfeldt. Brfeitenfeldt Group currently has over 300 5-star Google reviews, and Breitenfeldt believes that is a true testament to their team of experts and the one-to-one service they provide to their clients every day. And that customer service, he said, starts with good people who care about helping other people.
“When we look for employees, it’s the empathy and insight that we value most,” he said. “We pride ourselves in treating every client specific to their concerns and at their pace. There is no canned process or response. People want real answers from real people. Some just want to know what to do, others want longer explanations. We work hard to treat every client individually because everyone has different needs.”
Those who enroll through Breitenfeldt Group can work with their team of experts throughout the year. “We encourage our members to always make us their first call. Even if it’s as simple as ordering a new insurance card or asking about a bill. We know calling insurance companies can be a painful process,” said Breitenfeldt. “If it’s ever necessary to call an insurance company, we make that call for you, or with you, to resolve any service issues throughout the year.”
As individual needs change so can coverage during Medicare’s Annual Election Period, which runs every year from Oct. 15 to Dec. 7. Breitenfeldt Group understands these changes, and every fall they perform reviews to make sure each of their clients has the coverage that fits their needs.
“Your medical condition can change, your prescriptions can change, and the health insurance companies have the ability to make changes every year as well,” Breitenfeldt said, “Your plan should be reviewed every fall by an independent source, not someone who sells for only one company. We work with all the major carriers in the state. This gives us the ability to analyze your complete insurance needs and shop for you.”
One thing Breitenfeldt wants to point out, especially this year with the price of prescription plans rising, is that individuals should review their Medicare Advantage options.
“What I’ve seen each year is that Medicare Advantage plans continue to improve with more benefits and lower copays,” said Breitenfeldt, who added that more than 30 million Americans and 500,000 Minnesotans are now on a Medicare Advantage plan. “At Breitenfeldt Group, Medicare Advantage plans now account for more than 80 percent of our new business and we have hundreds of clients who change to a Medicare Advantage plan each fall during open enrollment.”
“These plans can offer significant savings and should be seriously considered, which is why I urge everyone on Medicare to schedule a review this fall,” said Breitenfeldt. “I understand none of us like change, but I feel very strongly they owe it to themselves to make a side-by-side comparison of their options.”
Breitenfeldt Group has offices in Alexandria, Long Prairie, Waite Park, Maple Grove, Edina, Woodbury, and Roseville, with a team of advisors covering the entire state of Minnesota. They also have an office in Appleton, Wisc., and can assist all Wisconsin residents as well. In addition to services in Minnesota and Wisconsin, Breitenfeldt Group is licensed in other states so they can assist those who move to warmer climates but still want their insurance taken care of by Breitenfeldt Group.
All office locations work together and are connected through state-of-the-art technology, meaning there is never confusion when a call comes in or a person stops by one of the offices. “It doesn’t matter who answers the phone, we know who you are and what is going on,” he said. “There is no starting over with each call.”
Having your own team of experts walking you through the process must cost something, right? Nope. All services by Breitenfeldt Group are offered at no charge.
“We will never send you a bill,” said Breitenfeldt. “Medicare plans are the same price and same coverage no matter where you get them, whether using an agent or buying directly from the insurance company. That means you won’t find a lower premium by shopping on your own.”
Those who are going onto Medicare for the first time or are already on Medicare and need help understanding their benefits, can contact Breitenfeldt Group toll free at 1-877-732-9800 or by email at info@BGhealthplans.com.
For their complete story and to get to know their group, visit Breitenfeldt Group’s website at BGhealthplans.com.
Not connected with or endorsed by the U.S. government or the federal Medicare program.
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