People with Medicare should already be well on their way to choosing their insurance for the following year. About 67.4 million people who are eligible for Medicare have already been sent the Medicare & You 2025 guide along with the annual notice of change (ANOC).
The ANOC “provides an overview of your current plan, highlighting any changes in benefits, coverage, medical and prescription drug costs, provider and pharmacy networks, service area requirements, and other administrative updates that will take effect in January 2025.” The handbook will cover any new developments, and the ANOC “provides an overview of your current plan.”
Fewer Medicare Advantage plans
The first change is that there will be a lot fewer Medicare Advantage plans. The author of “Maximize Your Medicare,” Jae Oh, says this is because of the rising cost of health care and the changes made by the Centers for Medicare and Medicaid Services. “So, carriers will be sending letters to people who are already signed up to let them know that the plans will be canceled.”
Some of the most notable changes are:
- Wellcare will discontinue offering Medicare Advantage (MA) products in six states Alabama, Massachusetts, New Hampshire, New Mexico, Rhode Island, and Vermont.
- Humana is exiting 13 markets nationwide.
- CIGNA is rolling back its Medicare Advantage plans in eight states.
- Aetna is dropping Medicare Advantage plans in 2025.
- CVS plans to downgrade its plan benefits and geographic presence next year.
In 2024, not all Medicare recipients were enrolled in Medicare Advantage plans. However, 54% of all eligible beneficiaries were. This means that these changes will touch about 32.8 million enrollees. Oh summed it up best: “It’s going to be a very hard year.”
Check out the ANOC and look for another plan in your area that will give you the benefits you need. This is the most important thing for beneficiaries to do.
$2,000 annual cap on out-of-pocket drug costs
The Inflation Reduction Act of 2022 made this change happen, and it only affects people who are signed up for Medicare Part D. After this change, people who get prescription drugs through the program will only have to pay up to $2,000 for them. This number will change over time because it is adjusted for growth.
Part D premiums will go up to meet the new cap, and the cost of medications can now be spread out over the course of the year. This means that people who take expensive medications will have a $167 limit on their monthly drug costs.
Melinda Caughill, co-founder of 65 Incorporated, said that this cap only applies to drugs that are covered by a person’s Part D drug plan. Keep that in mind. You will still have to pay the full price for the medicine if it is not paid.
Gender-neutral pricing
People who have Medicare supplement insurance, or Medigap, will be affected by this change. When setting prices for this service in the past, gender has been taken into account. Women, who owned 58% of Medigap policies, often paid less than men for their rates.
The American Association for Medicare Supplement Insurance (AAMSI) says that for a guy turning 65 in Phoenix in 2024, the lowest monthly premium for Plan G was $110.14. For a woman turning 65 in the same city, the lowest monthly premium for the same plan was $99.64.
The Affordable Care Act says that this price difference is unfair because it violates several anti-discrimination rules that should be used for all of their programs, such as Medigap. The rates for women will go up this year to make up for this difference, making them more expensive than they have been in the past.
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