As the open enrollment period for Medicare begins, significant changes are on the horizon for 2025. To help beneficiaries navigate this year’s updates, we spoke with David Lipschutz, co-director of the Center for Medicare Advocacy, who emphasized the importance of doing your homework when selecting a plan.
“Typically, people don’t actively compare and switch their health insurance plans. Most simply renew their current plans,” Lipschutz noted. “However, with the changes brought on by the Inflation Reduction Act, it’s crucial to shop around to ensure that your medications are still covered under your plan.”
Lipschutz explained that beneficiaries of Medicare Advantage and Part D plans tend to gain more from being proactive. “Unfortunately, many people either don’t compare options or glance at them just once before deciding they’ve done enough. This inertia often prevents them from undertaking the necessary work,” he said.
So, how should beneficiaries approach the changes coming in 2025? Here are some steps to consider:
1. **Review the Annual Notice of Change (ANOC)**: This document outlines the changes in Medicare Advantage plans for the upcoming year, including lists of in-network providers and pharmacies, updates to the formulary, and any pricing changes. Beneficiaries have the opportunity to modify their coverage between October 15 and December 7, with the enrollment period for Medicare Advantage plans running from January 1 to March 31.
2. **Examine Drug Coverage and Costs**: Different tiers of medications can affect out-of-pocket costs. Review the ANOC to check if the prescription drugs you currently take have been assigned to different tiers. It’s essential to ensure that your medications remain covered and understand their tier levels. Lipschutz recommends consulting with an insurance agent to review all medications and determine the best plan fit. You can also visit Medicare.gov or contact 800-MEDICARE for assistance.
3. **Understand Changes to Medicare Advantage Plans**: These plans often offer additional benefits compared to traditional Medicare. It’s crucial to understand which existing benefits will still be available in 2025. Keep in mind that some services might be restricted to specific provider networks, which could limit your options compared to traditional Medicare.
4. **Conduct a Comprehensive Cost Review**: Consider not just the monthly premium, but also deductibles, copays, and the accessibility of services when budgeting. Be sure to evaluate whether you can manage potential changes in premiums, provider availability, or out-of-pocket expenses. Lipschutz advises not to choose a plan solely based on the lowest premium, as it may lead to higher overall costs and less comprehensive drug coverage.
With these strategies, beneficiaries can better prepare for the upcoming changes to Medicare and ensure their healthcare needs are met efficiently.
