Buckle up, seniors.
The enrollment period for picking 2025 Medicare health-insurance coverage starts Tuesday, and it could be tough to navigate. Insurers are making changes that could leave you stuck with more costs and skinnier benefits. But you can still find good deals, if you know what to look for.
Specifically, some insurers are dumping plans, trimming popular offerings like dental coverage and increasing charges such as deductibles in response to new federal government requirements and to improve profits.
Because of the changes, about 1.5 million people will see their Medicare Advantage plans eliminated next year, while a further 3.5 million are losing their current Medicare drug policies, known as Part D plans, estimates Healthpilot, which offers a website to help people choose Medicare coverage.
“This is the largest disruption we’ve experienced in a decade,” says Healthpilot Chief Executive Seth Teich.
Among the people shopping around for a new plan is Peggy Watts Gup, a 70-year-old retiree who lives near Charlottesville, Va. Gup had liked the Aetna Medicare Advantage plan that she had been using the past four years, but it won’t be sold in 2025.
“I was like, darn, because I thought I could just do nothing and roll over the same plan,” she says.
Instead, she is finding that selecting a new plan is a challenge. Her first priority is to make sure that her preferred local hospital system and doctors are included. She also wants to limit out-of-pocket charges and make sure she can still fill her prescriptions.
With all the shifts, patient advocates say, seniors have to pay even closer attention than usual during this year’s Medicare open-enrollment period, which lasts until Dec. 7. Here’s what to watch for:
Nonpremium costs are going up
Average Medicare Advantage premiums are expected to decline next year, with many plans promising no monthly bill at all. But other types of costs might be rising, and you will want to delve into the details.
Watch for the maximum out-of-pocket cost, in particular. It is the total amount you could pay toward your medical care, including copayments and other charges. Healthpilot estimates the overall average is going up by a little over $450 next year in Medicare Advantage plans, to about $5,929. (The figure is for in-network care and excludes special-needs plans.)
Some companies are leaning harder on the charges than others. Wall Street analysts at Leerink Partners found that Humana will have, on average, the largest increases in maximum out-of-pockets among the big Medicare insurers, followed by Aetna and UnitedHealthcare.
A spokesman for Aetna parent CVS Health said the insurer “remains laser-focused on delivering the exceptional service that keeps our Medicare Advantage members healthy,” and nearly 90% of its members are in plans with high quality ratings. In many markets where the insurer has removed a plan, other Aetna products are available, he said.
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