Numerous Changes Coming To Medicare Advantage As Open Enrollment Begins

Medicare Advantage enrollees are advised to review their plans during the open enrollment period, which begins on Tuesday (October 15), as insurers are implementing numerous changes that could affect seniors' policies in the coming year. Despite the overall stability of the rapidly growing market, these changes could result in some seniors needing to find new policies, paying more out-of-pocket, or receiving fewer supplemental benefits.

"In recent years, this is the most benefit disruption we've seen in the market," said Lindsay Knable, a partner in consulting firm Oliver Wyman's health and life sciences practice, in an interview with CNN.

Medicare Advantage enrollment is projected to reach 35.7 million, accounting for 51% of total Medicare enrollment. The program, an alternative to traditional Medicare, contracts with private insurers to provide Medicare coverage to beneficiaries, many of whom are on fixed incomes. However, few enrollees shop during open enrollment, which runs until December 7. A recent analysis by KFF, a health policy research organization, found that nearly two-thirds of Medicare Advantage participants did not compare their coverage with other options for 2022.

This year, more than 1.8 million Medicare Advantage members, or roughly 8% of those in non-group, non-special needs plans, are enrolled in policies that won't be offered in 2025, according to an Oliver Wyman analysis. About 1.3 million of them are currently enrolled in $0 premium plans. They will have to actively select new plans, or they'll be placed in traditional Medicare. By comparison, roughly 230,000 members, or about 1%, were in this situation for 2024.

Humana and Aetna are the most aggressive in trimming their offerings, with about 10% of their membership affected by the changes, according to David Windley, senior equity analyst at Jefferies. About 5% of enrollees in UnitedHealthcare and Centene policies will be affected.

Still, nearly all senior citizens will have a bevy of other options to choose from. On average, they'll have 34 Medicare Advantage plans with drug coverage to choose from in their county for 2025, down from 36 this year, according to the Centers for Medicare and Medicaid Services.