October 14, 2025
Navigating The Changes to Medicare Advantage Plans
Navigating the changes to Medicare Advantage: What you need to know
With the Medicare Annual Enrollment Period (AEP) upon us, many seniors and other Medicare beneficiaries are reviewing their healthcare options for the upcoming year. This year, however, many are finding that their current Medicare Advantage (MA) plan is being dropped, altered, or restricted. Major insurers are scaling back their offerings, causing market disruption and raising concerns for millions of enrollees.
If you have been notified of a change to your plan, you are not alone. Here’s a look at what’s happening and what you should do next.
Why are insurance companies dropping or changing plans?
Several factors are driving insurance companies to reassess their Medicare Advantage offerings. After years of rapid expansion, many are now prioritizing profitability and responding to new market and regulatory pressures.
- Decreased government funding: Changes in federal payment rates have reduced the amount of reimbursement insurers receive for providing MA plans. The government has also made adjustments to the risk adjustment model, which has also impacted funding.
- Rising healthcare costs: Insurers face higher costs for hospital stays, doctor visits, and prescription drugs. This has prompted many to re-evaluate what benefits they can offer without raising premiums.
- Shift in focus to profitability: After a period of aggressive growth, many insurers are now seeking to increase their profit margins. This has led them to exit less profitable markets, particularly in rural or competitive urban areas, and to cut back on benefits for higher-utilizing members.
- Part D benefit redesign: Regulatory changes from the Inflation Reduction Act have placed more financial responsibility on insurers for high-cost drug coverage. This has led some to add drug deductibles or modify their drug formularies.
What does this mean for beneficiaries?
The changes in the MA landscape could affect your coverage and budget in several ways:
- Fewer choices: The number of available MA plans has decreased for 2025 in many areas, though some insurers are expanding into new counties. Some providers are also dropping certain MA contracts, meaning your doctor may no longer be in-network.
- Increased costs: Many plans are introducing or increasing prescription drug deductibles to manage higher costs, especially for expensive medications. While the Inflation Reduction Act caps out-of-pocket prescription costs, some plans are also increasing their maximum out-of-pocket limits for medical services.
- Changes to supplemental benefits: Some plans are reducing the “extra” benefits they offer. These include benefits that address social needs, such as transportation, meals, and over-the-counter allowances.
How to protect yourself during AEP
Even if your plan is changing, you have options. The Medicare Annual Enrollment Period (October 15–December 7) is your chance to review your coverage and make a change.
- Read your Annual Notice of Change (ANOC): Your plan was required to send you an ANOC by September 30. This document details all changes to your premiums, copayments, deductibles, and benefits for the upcoming year. If your plan is being terminated, the ANOC will inform you of your need to find new coverage.
- Use the official Medicare Plan Finder: Compare all available plans in your area using the online tool at Medicare.gov. This is the most reliable way to find which plans cover your doctors and prescriptions at the lowest cost.
- Don’t ignore the changes: If your plan is terminating and you do nothing, you could be automatically enrolled in a different plan by the same company—one that may not fit your needs. Some beneficiaries who take no action may also be returned to Original Medicare, potentially without a drug plan.
- Explore all your options: Consider whether another MA plan, Original Medicare with a Part D drug plan, or a Medigap policy is best for you. If you choose Original Medicare, be aware that you will likely need to go through medical underwriting to get a Medigap policy, which could result in higher premiums or denial of coverage if you have certain health conditions.
- Get personalized help: Confused about your options? Contact your local State Health Insurance Assistance Program (SHIP) for free, unbiased counseling. You can also call 1-800-MEDICARE for help.
This year’s enrollment period is more critical than ever. By staying informed and comparing your options, you can make a confident decision and ensure your healthcare needs are covered in the year ahead.