Thousands of seniors are facing the loss of their Medicare Advantage coverage next year, with roughly 25 percent of plans expected to no longer be available in 2025. Many private insurers are cutting their plans due to rising costs, in part because of changes brought about by the Inflation Reduction Act (IRA). The IRA put pressure on insurance providers by lowering reimbursement rates and introducing prescription drug caps and reduced base payments to Medicare Advantage insurers, leading many insurers to pull out of markets they deem no longer economically viable.
In Oregon, Moda Health, Summit Health, Regence BlueCross BlueShield of Oregon, Aetna, and PacificSource have all announced they will be ending Medicare Advantage plans next year. More than 12,000 Oregonians are expected to need to find a new healthcare plan as a result of these cuts. Some counties, such as Curry, Harney, Lake, Umatilla, and Union, will no longer have any Medicare Advantage plans available, forcing seniors to choose traditional Medicare instead. Other areas, like Coos County, will only have one Medicare Advantage plan to choose from in 2025.
Seniors affected by these changes will need to choose a new plan during a special enrollment period from December 8 through February. If coverage is desired in January, a choice must be made by the end of the year, otherwise, individuals will be automatically enrolled in Medicare Part A and B and will need to sign up for prescription drug coverage separately. The changes in Medicare Advantage plans highlight a significant drawback in comparing privatized plans with traditional Medicare, as there is the potential for plans to not be renewed each year, especially amid financial pressures facing insurance companies.
The financial pressures facing insurers have led to smaller insurance companies terminating several plans due to the inability to keep up with higher costs and lower reimbursement rates. Seniors now face the burden of navigating these changes and finding new healthcare options. The cuts are putting pressure back on seniors, who are one of America’s most vulnerable groups. The fear of not knowing where to turn for help in navigating these changes is a common concern, but it is advised to find a trustworthy and knowledgeable agent to assist in understanding coverage options.
Looming cuts to Medicare Advantage plans are a growing concern for seniors who may face the challenge of having to constantly seek out new healthcare options during their golden years. The changing nature of the insurance industry and the financial pressures faced by insurers are contributing to the termination of many plans, leaving seniors in need of new coverage. It is important for seniors affected by these changes to understand any communications they receive from their insurers and take necessary action to secure new coverage. As the landscape of healthcare continues to evolve, seniors must be vigilant in advocating for their healthcare needs and ensuring they have access to the care and services they require.
