Do you already have a Medicare Advantage plan?
When did you first enroll?
Have your medical needs changed?
Considering this and adjusting your Medicare Advantage plan is essential to ensure you get the best coverage for your current health situation.
Do you let your plan roll over?
It’s crucial not to let this happen and to actively review your plan to ensure it continues to meet your needs.
When was the last time you checked the options available to you?
Did you know you have until MARCH 31st to update your Medicare Advantage plan?
In 2024, over half (33.9 million people) of Medicare (part) A enrollees also had an Advantage plan. Advantage plans can be chosen to meet personal preferences for doctors, specialists, hospitals, or care providers. Advantage plans can be tailored to meet individual needs for prescription drugs and procedures. In short, advantage plans combine federal and state subsidies with enrollee contributions to ensure seniors and individuals with certain chronic conditions benefit from many otherwise unaffordable medical services, including post-acute care, home health care, and preventive services.
When did you first enroll? Have your medical needs changed?
If you have a Medicare Advantage plan, you probably enrolled in the year you qualified for Medicare (part A) and made a considered choice of the additional coverage that was appropriate at the time. Since then, your medical circumstances and the medical and care services you need have almost certainly changed. And certainly, your provider network, your covered drug list, and your premium and cost-sharing (co-insurance or co-payment) have changed. You may be paying more than you need. You may miss out on the benefits covered in other plans.
Do you let your plan roll over?
You are not alone if you have left your Advantage plan to roll over. Between 89% and 94% of enrollees do not change their plans from one year to the following (KFF analysis). Many beneficiaries do not even compare their coverage options. Last year’s plan may still be the most appropriate option, but it is impossible to judge without comparing other plans available in the marketplace.
The KEF analysis suggests that older groups are least likely to change their plans or switch providers. However, these are the groups most likely to need to take full advantage of the opportunity to reassess their coverage regularly.
By the end of September 2024, all enrollees in Advantage plans should have received an Annual Notice of Change (ANOC), which will include any changes to their plan.
The changes you should look out for are: –
- Changes to your insurance provider’s formulary (the drugs covered by your health insurance plan. NOTE: – You cannot have both an advantage plan AND a stand-alone drug plan. For 2025, the OOP limit for drugs has been brought down to $2000. For this reason, many insurers have revised their formulary. Make sure that your plan still covers the drugs you rely on.
- Average Medicare Advantage premiums were forecast to come down or remain static for 2025. If your premium has gone up, you should be satisfied that there has been a corresponding improvement in coverage or service.
- Some insurers have changed their benefits, which could mean that your deductible, your levels of coinsurance, and copays have changed.
- Possibly some supplemental benefits have been reduced or even withdrawn.
- Last and probably most importantly, provider networks can change. Ensure that the providers you depend on are in your 2025 network.
If you took no action during OE, your 2024 plan will automatically renew on January 1st, 2025, and these new conditions will apply.
Medical Advantage Open Enrollment Period (MAOEP)
Your Medical Advantage plan has a rare and welcome advantage. It gives you the opportunity to ‘change your mind.’
Maybe you selected a new plan, changed your provider during Open enrollment, or allowed your plan to roll over. Perhaps you now have second thoughts. MAOP gives you the ‘window of opportunity’ to change your mind. Between January 1st through March, you can decide on a plan change that offers you better value for your insurance dollar, a plan (s) more suited to your specific needs.
The process is straightforward—find, choose, and submit a plan (s) before the end of March. Your existing plan will be replaced by a new one the following month. It sounds easy, but the hard part is choosing ‘the’ plan. You could be faced with dozens of multiple-choice questions. This is why so many people take the easy (and costly) route and let their plans roll over.
Make the hard part easier. Expert advice from a qualified, independent broker or agent will cost you nothing. Their experience and local knowledge can help you make decisions that give you greater security and peace of mind, possibly saving you $ thousands.
