Medicare Advantage Changes This Fall: What You Need to Know
As the Medicare Annual Enrollment Period begins today, seniors across the country will weigh their health care options and be empowered to choose the coverage plan that works best for them. A record number of seniors and people with disabilities are expected to choose Medicare Advantage for affordable health care, according to CMS, with the program expected to grow to 35.7 million Americans next year, or more than half of the Medicare population.
In any year, it’s important for seniors to review their coverage and understand their options — but this may be particularly true this year, as many seniors enrolled in Medicare Advantage will face unexpected changes to their plans.
Recent policy shifts in Washington are projected to cause significant coverage disruptions, with around 2 million Medicare Advantage beneficiaries needing to switch plans for next year — substantially higher than the typical 100,000 in years past, according to ATI Advisory.
These changes are the result of recent policy decisions in Washington, including insufficient Medicare Advantage payment rates, changes to how the government subsidizes care for different illnesses, and provisions in the Inflation Reduction Act. These pressures are creating real consequences for seniors who rely on Medicare Advantage for their health care.
Maximum out-of-pocket costs will rise by an average of $400 nationally, and many plans will be scaling back benefits like transportation, meal deliveries, and in-home support, according to an analysis by Avalere on behalf of Better Medicare Alliance. While some regions will feel these effects more acutely than others, the national trend is clear.
But there is a silver lining: premiums for the average Medicare Advantage enrollee will remain stable next year, with an average premium of $17 in 2025 compared to $18.23 in 2024. Another bright spot is telehealth; the number of plans offering that benefit grew from 82% to 97%. Seniors depend on these critical benefits and affordable out-of-pocket costs, both of which are under pressure. And while stable premiums are welcome news, they are just one part of the equation for beneficiaries.
This doesn’t need to be the new normal, however. Policymakers in Washington can protect seniors by ensuring Medicare Advantage receives sufficient funding to maintain the benefits and coverage that millions of beneficiaries count on.
With a record 2 million new beneficiaries expected to join Medicare Advantage this year, it’s clear the program is growing—and for good reason. Medicare Advantage consistently delivers better care at a lower cost than Fee-For-Service Medicare, saving seniors an average of $2,541 annually in premiums and out-of-pocket costs. Medicare Advantage also provides important benefits like vision, dental, and hearing coverage all in one plan.
Seniors deserve an affordable health care option they can count on, and Medicare Advantage is working for nearly 34 million Americans.