Dear AMAC,

I’ve had the same Advantage plan for a few years, and I noticed my plan doesn’t change much each year. Do I really need to do anything during annual enrollment, or can I just save myself the time and stick with what I have?

-Tim

Houston, TX

Hello Tim,

You may have lucked out in the past by coasting with the same plan, but there will be quite a few changes that will affect ALL Medicare beneficiaries next year. For that reason, we highly recommend that you review your coverage before deciding to stay with your plan.

Start by reviewing your Annual Notice of Change (ANOC), which you should receive sometime in September. Your plan premium, benefits, deductibles, and copays are the major items to take note of.

Even if those items look satisfactory to you, you’ll want to make sure your prescription medications are still covered, and that your providers are still in-network. These items may not be noted in your ANOC, so additional research is key!

Here are some of the changes that will affect your coverage:

• Drug deductible: Most Prescription Drug plans (and Advantage plans that include Part D) will have a deductible increase. Deductibles for plan year 2025 cannot exceed $590.
• Elimination of the Coverage Gap: The coverage gap will no longer exist as of 2025. After meeting their deductible, enrollees will pay a portion of covered drug costs until the out-of-pocket threshold of $2,000 is met. Afterwards, enrollees pay nothing for covered drugs.
• New Drug Payment Plans: Beneficiaries can now choose to spread out their drug costs using manageable payment plans rather than paying a large sum all at once at the pharmacy. Payment plans must be set up with your insurance provider.
• Medicare Advantage Plan Benefits Reduction: It is possible that many Advantage plans will begin cutting back on additional benefits such as dental, over-the-counter allowances, and Part B givebacks. This is due to cuts in federal funding and increased plan spending.

As you can see, there are many new variables this year. Ultimately, the decision is yours to make, but if you choose to do nothing, you could be stuck with coverage that will cost you more down the road. If you do decide to evaluate your options, give us a call.

Thank you for taking the time to write to us, Tim!

AMAC’s Medicare Advisory Service connects you with friendly, knowledgeable agents who can tell you which plans cover your doctors, prescriptions, and everything else that’s important to you. Contact us today and let us do the same for you. You’ll be happy you did!

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For help with Medicare plans – or any questions you may have about Medicare – contact AMAC’s Medicare Advisory Service at 1-855-611-4856 or request a quote below!