2025 Medicare Annual Notice of Change will be vital reading this fall

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Lethe200

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Why this year’s Medicare Annual Notice of Change will be vital reading for beneficiaries
Fortune magazine 26Aug2024
[free link] Why this year’s Medicare Annual Notice of Change will be vital reading for beneficiaries (msn.com)

(excerpt)
If you’re on Medicare, you’ll be getting one or two Annual Notice of Change letters in your mail or email this September about your 2025 coverage and costs. You may be tempted to ignore what looks like junk, as nearly a third of recipients do, according to an eHealth survey.

Don’t.

... While this information is always essential to make smart choices during Medicare’s eight-week Open Enrollment period (Oct. 15 – Dec. 7), experts say reading your Annual Notice of Change is especially important in 2024.

“There is an excellent chance that something is changing on your plan,” says Roberts. “This year, more than ever, we can expect big changes in the plans.”
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NOTE: Be sure to read the last section, “Getting help if your Medicare plan will change”– it has helpful links and tips!
 

We just received our new plan changes for 2025 today, and I read through everything. Some of the extra benefits seem better, and some not as good as this year. Our preferred doctor is not in our plan company, so we have an appointment with our insurance agent to go over all of the new plans and see which company has the best plant for our needs next year.
If Devoted health and Humana are comparable next year, we will go back to Humana so we can have our old doctor back again .
 
I attended a seminar on Medicare 2 years ago. During the question and answer segment, I explained what I had. The speaker said I have the best plan available under my circumstances and not to change. If I opt out of traditional Medicare and go to an Advantage plan, I can never go back once I switch, if I don't like the Advantage option.
 
debodun said:
I attended a seminar on Medicare 2 years ago. During the question and answer segment, I explained what I had. The speaker said I have the best plan available under my circumstances and not to change. If I opt out of traditional Medicare and go to an Advantage plan, I can never go back once I switch, if I don't like the Advantage option.
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I don't recommend the Advantage plan. In fact, I strongly recommend avoiding it.

(unrelated) What that article doesn't mention is that one of our presidential hopefuls plans to shift medicare funds to cover a nationwide healthcare plan. Surely that will effect senior medicare benefits, probably significantly.
 
debodun said:
If I opt out of traditional Medicare and go to an Advantage plan, I can never go back once I switch, if I don't like the Advantage option.
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That's not correct, even if on an advantage plan you are still enrolled in Medicare. During the plan year you can't switch but during the open enrollment period you can drop the Advantage plan and be back on traditional Medicare.
 
I received my advantage plan change documents for next year and it looks like some fairly substantial changes in copays and deductibles for next year.

Pay close attention to copays and deductibles for hospitalization and for changes to the various tiers in the drug formulary.

Still an amazing deal for a zero premium plan.
 
C50 said:
That's not correct, even if on an advantage plan you are still enrolled in Medicare. During the plan year you can't switch but during the open enrollment period you can drop the Advantage plan and be back on traditional Medicare.
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It may be that Deb’s plan through NYS, her former employer, is considered to be a Medigap plan.

Medicare will not allow a person to have both a Medigap plan and an Advantage Plan.

Switching might cause her to lose the NYS plan.

🤔
 
Aunt Bea said:
It may be that Deb’s plan through NYS, her former employer, is considered to be a Medigap plan.

Medicare will not allow a person to have both a Medigap plan and an Advantage Plan.

Switching might cause her to lose the NYS plan.

🤔
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That makes more sense.
 
There are Medicare Advantage plans that are customized for an employer, in my case, AZ state retirement. It was a difficult choice since it covered vision and hearing plus it was free (no premium after subsidy) to retirees. I took a Plan G/D instead. Deciding factors were in/out of network issues, copays, UHC deciding needed care (instead of Medicare*) and the $6,000 annual out of pocket.

I do pay a monthly premium for Plan G/D though, but after the $240 annual deductible, I never pay another cent. I don’t even see the paperwork unless I log in to view claims. I see that premium as the price to pay for no headaches. I did take the state dental plan though, which was free. I am on my own with vision care.

*This was the biggest factor for me. UHC has a negative reputation for refusing to approve Advantage Plan claims.
 
C50 said:
That's not correct, even if on an advantage plan you are still enrolled in Medicare. During the plan year you can't switch but during the open enrollment period you can drop the Advantage plan and be back on traditional Medicare.
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don't you have to do underwriting to go back?
 
Got my blurb from Highmark Blue Shield Senior Healthcare. Some minor 'worse' things, one minor 'better' thing, and one large bad thing, which is that Highmark is dropping the Silver Sneakers fitness benefit and replacing it with what seems to be a garbage fitness benefit called Fiton.
 
 
Got the letter with the new cost of my silverscript part D. They are quadrupling the monthly premium (from $12 to $47) and doubling the deductible ($280 to $590). And adding copay amounts too!

So I guess when open enrollment starts next week I will switch to the Wellcare Value Plan which looks like it will be totally free as long as I don't have any changes in my current medications. But, it is hard to see how it can be zero monthly and zero for the prescriptions I take, I worry that if something happens that requires me to have different meds that perhaps it would wind up being a lot more expensive.

Also, I'm leery of the way the medical plans might drop covering medications to get around the new $2000 maximum-out-of-pocket rules. Though it looks like Medicare requires all the plans to cover all the common medications.

Is the donut hole gone now?
 
HoneyNut said:
Got the letter with the new cost of my silverscript part D. They are quadrupling the monthly premium (from $12 to $47) and doubling the deductible ($280 to $590). And adding copay amounts too!

So I guess when open enrollment starts next week I will switch to the Wellcare Value Plan which looks like it will be totally free as long as I don't have any changes in my current medications. But, it is hard to see how it can be zero monthly and zero for the prescriptions I take, I worry that if something happens that requires me to have different meds that perhaps it would wind up being a lot more expensive.

Also, I'm leery of the way the medical plans might drop covering medications to get around the new $2000 maximum-out-of-pocket rules. Though it looks like Medicare requires all the plans to cover all the common medications.

Is the donut hole gone now?
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Check your plan’s drug formulary to see which tier your drugs are in and what the copay will be.

My plan has changed quite a bit and some new wonder drugs now have a 30-50% copay. Most of my old generic drugs are still free to me.

It’s my understanding that the donut hole is gone but $2,000.00 out of pocket is still a chunk of money to shell out in potential copays.

The biggest risk and cost associated with my Advantage Plan is the copay for hospitalization at $440.00/day.

Do your homework and continue to check your plan as you discuss new medications and treatment options during the year with your PCP.

Good luck!
 
All that I have ever had is an advantage plan, and they have paid for all of the medical procedures that I have needed for my heart, with no problems at all.
I see people advising against the MA’s, but they never say what they personally didn’t like, just what they have heard bad about the advantage plans.
Most of the people who actually have an advantage plan seem to be like me, and really like them, and all of the extra benefits which come with an advantage plan.

We talked with our previous doctor’s office again today, and they still are not accepting the Devoted Health insurance, and Devoted still seems to be the best plan for us; so we are going to try and find a different doctor that we like because we can’t actually get through to our old doctor, and his office manager is completely useless to talk with.
She said they didn’t want devotedbecause they do not play claims from their patients, but that is because they never registered with Devoted in the first place. If they had done that, then they would have been paid, but she can’t seem to understand that And refuses to even call and talk with the company.
I called Devoted to see if they could talk with our doctor , but they can’t do that unless it was me whose bill was not being paid, which is understandable.
 
Happyflowerlady said:
All that I have ever had is an advantage plan, and they have paid for all of the medical procedures that I have needed for my heart, with no problems at all.
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Same here.

I'm not sure where the anti-Advantage sentiment comes from. Nothing is perfect, but rejection of this approach out of hand seems ridiculous. Maybe it stems from lack of coverage for voodoo, chiropractors, faith-healing, and the like?

The MA plan offered and partially paid for by my prior employer is also the only plan they provide financial support for that is "portable" across States if I were to move. Otherwise it's all out of pocket, sacrificing a valuable retirement benefit.
 

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