It's Finally Here!

It’s finally here! Medicare Annual Enrollment Period (AEP) started this morning! AEP is a happens every year between October 15^th and December 7^th. During AEP you can join, switch or drop a Medicare Advantage Plan or Medicare drug plan. You can also switch to Original Medicare during this enrollment period every year.

As a Health Insurance Broker, I talk to people all the time who are already enrolled in Original Medicare and have some other plan to supplement what Original Medicare doesn’t cover, whether it is a Medicare Supplement or Medigap plan and a Prescription Drug Plan (PDP), a Medicare Advantage Plan (MA), or are covered by Tri Care. They frequently tell me, ‘Aubrey, I’m happy with what I have, I don’t need to make any changes.’ I respect that. I am a person who doesn’t like change, and when I find something that works for me, I am loath to make any changes. My response with Medicare, or health insurance in general, is that you don’t have to make any changes, but you should review every year to make sure your plan is still a good fit for you.

Not only is it a good idea to make sure what you have still works for you, it is also important to know what changes there might be to your plan. Almost every Medicare Advantage and Prescription Drug Plan has some sort of change at the beginning of the year. It may be that benefits go up or down, premiums change, or the formulary (list of covered prescriptions) has changed.

This Annual Enrollment Period is more important than ever to review your coverage for 2025. Why this year? Because of the Inflation Reduction Act, there are a couple of great changes coming to Medicare Prescription Drug plans. The coverage gap or ‘donut hole’ has been eliminated, and the Annual Max Out of Pocket has been lowered from $8000 in 2024 to $2000 in 2025. These changes will affect millions of Americans by lowering their annual drug costs.

These changes, more than some of the changes already brought about by the Inflation Reduction Act in the past couple of years, have impacted different Medicare Advantage and Prescription Drug Plans. With the increased risk for both health insurance companies and pharmaceutical companies, most plans have been adjusted to help offset that risk. When I was finally able to see what the plans for 2025 looked like I was pleasantly surprised. Earlier in the year when I heard about the donut hole being eliminated and the $2000 max out of pocket, I feared much higher premiums and lower benefits. While there have been some plans with increased premiums, and some plans with decreased benefits, overall, the changes have been reasonable and much less than I expected.

That being said, I still affirm the importance of reviewing your coverage. Many plans have deductibles where they didn’t have before, and premiums and benefits did change. My goal as a broker is simply to educate people of their options and assist them in finding the coverage that works best for themselves and their families. If you have an agent or broker already that is great, set up a time to review your options. If you don’t, I’m a firm believer in finding someone local who is familiar with the ins and outs of the laws and plans in your state. A broker should never cost you anything, but having a good one could save you money and keep you informed of how your coverage will change in 2025.