One million people to lose Medicare Advantage Plan for 2025

If you have a Medicare Advantage plan, be sure to read your Annual Notice of Change the insurance companies are required to mail you each September. This year’s notice could be shocking!

Many companies have announced that they are leaving counties and some are leaving entire regions or states. Aetna was the most popular choice for Medicare Advantage last year. But they said that over half a million members will lose their plans this year.

This is called a Plan Exit, and while it is usually bad news, it comes with some good news, too!

If you get a notice that you are losing your Medicare Advantage plan, you will not be without options. You are guaranteed to move into another Medicare Advantage plan (if there is one in your county). The really good news is that you can get a Medicare Supplement without health underwriting. If you have wanted to move into a Medicare Supplement plan, now is your chance. You can enroll with any company and they have to accept you – regardless of your health.

Why is this happening? Because private Medicare Advantage plans have several financial challenges this year: the impact of the new Medicare Part D rules, medical inflation, and lower reimbursement from the government. Since plans are filed by the county, if your county is not profitable, the insurance company can always leave your market. The company might be profitable in a nearby county, which is confusing. Hospitals and doctors charge different amounts and insurance companies may not find your area to be profitable.

This isn’t new. However, unlike recent years, this year will see a lot more plan exits than an average year. Insurance companies are blaming some of this problem on COVID. People are using their insurance plans more often and it’s being attributed to the lingering effects of COVID. People put off procedures they are not getting back around to. People are often suffering from the effects of long COVID, and some people have a major condition that could have been caught earlier (and treated cheaper) if COVID hadn’t hampered their ability to get routine and preventative care.

All of the things that are hurting Medicare Advantage profits, and thereby your own out-of-pocket costs, are also hitting Medicare Supplement plans. I’ll talk about that in a later issue, but note that you are not immune from these market pressures. Medicare Supplement plans are predicting double digit increases but you won’t see that news until January. The news about Medicare Advantage comes in September.

Sylvia Gordon is known as Medicare Mama on social media. She and the Noblesville-based TheMedicareFamily.com have amassed nearly one million followers online where she teaches about Medicare, Social Security, and retirement.