Medicare recipients should already be well under way into deciding their policy for next year. The Medicare & You 2025 handbook has already been distributed to the roughly 67.4 million beneficiaries that take part in the program accompanied by the annual notice of change (ANOC).

These two documents are key for a smooth annual transition, the handbook will cover any new developments while 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.”

Fewer Medicare Advantage plans

The first change is that the number of Medicare Advantage plans will be severely reduced. According to Jae Oh, the author of “Maximize Your Medicare” this is because of the increased cost of healthcare and the changes that the Centers for Medicare and Medicaid Services has implemented “As a result, carriers will be sending letters to inform existing enrollees 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.

Although not every Medicare recipient was enrolled in Medicare Advantage plans in 2024, 54% of the total eligible beneficiaries were, meaning that these changes will affect around 32.8 million enrollees. As summed up by Oh “It’s going to be a very complicated year.”

The most important thing for beneficiaries to do is to review the ANOC and search for an alternative plan in your area that will give you’re the coverage that you need.

$2,000 annual cap on out-of-pocket drug costs

This change affects specifically those that are enrolled in Medicare Part D and is brought on by the Inflation Reduction Act of 2022. This change means that there will now be a $2,000 cap on out-of-pocket spending for prescription drugs covered by the program. This figure will change throughout the years as it is indexed for growth.

The premiums for Part D will increase to cover the new cap, and the cost of medication will now be able to be spread out throughout the year, which, for those on expensive medication, will put a $167 cap on their monthly drug expenses.

But just remember that this cap only applies to medications are covered by a person’s Part D drug plan, as explained by Melinda Caughill, the co-founder of 65 Incorporated. If the medication is not covered, you will still pay the full cost.

Gender-neutral pricing

This change will affect Medicare supplement insurance, also known as Medigap, beneficiaries. This program has historically taken gender into account when issuing pricing. Women, which made up 58% of Medigap policyholders, were often paying lower premiums than men.

According to data from the American Association for Medicare Supplement Insurance (AAMSI) “In 2024 for a man turning 65 the lowest monthly premium for Plan G in Phoenix was $110.14, but for a woman turning 65, the lowest monthly premium for the same plan in the same city was $99.64.”

This disparity in pricing has been deemed discriminatory by the Affordable Care Act, as it contains several nondiscrimination rules that should apply to all their programs, including Medigap. To compensate for this gap, women’s premiums will see a rise this year and will thus be higher than they have been in the past.

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