The 2025 Medicare Annual Enrollment Period (AEP) just ended. And we’re now in the Open Enrollment Period (OEP). This is the period of time that many seniors may not know about. If a senior decided to keep the same plan they had in 2024 or signed up for a new Medicare Advantage Plan during the AEP for 2025, and now are finding that their plan does not meet his/her needs, there’s a possibility that they can change their Medicare Advantage Plan during the OEP. This OEP period promises to be a busy time, because Medicare has reduced the annual prescription out-of-pocket expense that seniors have to pay from $3,000 to $2,000. While many seniors never hit the cap, according to AARP, nationally they’re estimating 3.2 million seniors will exceed the $2,000 cap, and insurance companies are responsible to pay/cover those costs. So, many insurance companies made numerous changes to their Medicare Advantage plans (which has both health insurance and prescription drug coverage) for 2025 including:
· Cutting plans
· Making changes to their drug formularies (the drugs they’re going to cover)
· And/or increasing the co-pays on lower-tiered prescriptions (such as generics) that may have had $0 co-pays, or say $5 co-pays, and now seniors are being charged more.
· They’re also trimming other health benefits, such as dental coverage.
As a result, experts are estimating that over 6 million seniors who stayed on their 2024 Medicare Advantage Plan in 2025, will see significant changes in the form of increases in drug co-pays, or drugs not covered any longer and/or reduced health benefits that used to be covered.
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