Medicare Advantage plans are widely popular in the United States. The Kaiser Family Foundation estimates that they enrolled more than half of Medicare beneficiaries for the first time in 2024, a milestone for such private health plans.
However, important changes are coming to the program at the federal level and some people enrolled in Medicare Advantage plans or who are being considered should pay attention and evaluate what will happen when open enrollment begins this fall of 2024. There may be significant modifications to existing plans or plans that will be offered to new beneficiaries or users.
Changes Coming Over Medicare and Medicare Advantage
The popularity of Medicare Advantage plans lies in the benefits, they are relatively good, because for relatively healthy beneficiaries, the overall out-of-pocket costs are lower than for an original Medicare package, supplemented with supplemental Medicare insurance and Medicare part prescription drug insurance.
Companies that offer Medicare plans also often add some extra benefits that are usually not included in the original federal Medicare plans. The problem is that Medicare continues to consume an increasing percentage of federal government spending every year according to estimates by the Centers for Medicare and Medicaid.
Federal lawmakers are analyzing what to do to ensure long-term sustainability, and that could mean changes and cuts in the scope of benefits and coverage of Medicare Advantage plans.
What Could Change in Medicare in 2025?
Projected changes to Medicare Advantage plans could include higher premiums, co-pays and deductibles than you’ve already been paying to this day. At the same time they could start offering smaller coverages. This is due to the continuing pressure to reduce spending on Medicare, especially on Advantage plans that consume as we said earlier part of the federal budget.
Companies such as UnitedHealth and CVS Health have recently publicly warned about the possible reduction of profits in their Medicare Advantage plans due to changes in payments to the providers of these plans. CVS, for example, experienced higher usage of medical services by its members in the first quarter, which could impact its profit margins.
Possible Coverage Cuts Coming
Additionally, Medicare is currently adjusting what the program covers. Could I stop paying for certain blood tests that detect early signs of organ transplant rejection? This is one of the many cases of types of coverages that they are analyzing and their continuity could be at risk. Which could be an indication of more original Medicare and Advantage coverage reductions.
It remains to be seen what the changes are that are materialized and what effect it will have on Medicare beneficiaries. That they should carefully monitor what happens in the short term with a view to 2025. This also applies to those people who are considering joining a Medicare Advantage program in whatever State they reside in.