How Can Your Current Medicare Plan Change Next Year?

Many people are reluctant to change their Medicare Part D or Medicare Advantage plan coverage year-to-year.

However, millions of Medicare beneficiaries will see significant changes in their Medicare costs and coverage.

If you are staying with your current Medicare plan into next year, please be sure to review your plan’s Annual Notice of Change (ANOC) letter and use this list to help you look for important coverage changes that might impact your coverage next year.

And remember, there are no health-related questions should you decide to change your Medicare Advantage plan or Medicare prescription drug plan (however, Medicare Advantage Special Needs Plans require that you meet the plan’s specific “need”).

Your Medicare Plan May No Longer Be Offered Next Year

Many folks are currently enrolled in a Medicare Advantage plan (MA or MAPD) that will no longer be available next year. We can help you determine what will be happening with the plans you are looking at, or the ones you are currently enrolled in.

You May Be Automatically Reassigned to a Different Medicare Plan Next Year

Every year, many people enrolled in Medicare Advantage and/or Part D Standalone plans are automatically "crosswalked" into another plan for next year. Normally, you will be notified if you are in this group but we are more than happy to help you know for sure.

Your Medicare Plan May Change It's Name

Sometimes, your Medicare plan (no matter what type it is) may be changing its name. Along with a name change, it could also have different features.

Your Monthly Medicare Part D Premium May Be Increasing

Many Medicare beneficiaries will see their monthly Medicare Part D premium increase 20% or more. Some people currently enrolled in a Part D plan will see their plan premium double next year. The good news is that there is a group of people that will see a premium decrease of 10% to 63% next year.

Please keep in mind that in addition to lower-premium Part D plans, there may be low- or $0 premium Medicare Advantage plans (MAPDs) available in your area.

Your Plan’s Initial Deductible May Increase

Typically, the Medicare Part D deductible increases year-over-year. The exact amount can also depend on your situation.

Your Medicare plan’s Initial Coverage Limit (ICL) may change

Almost all stand-alone 2022 Medicare Part D plans use the standard Initial Coverage Limit (ICL), though some 2022 Medicare Advantage plans offer an ICL other than the standard, ranging higher and lower.

Your drug plan’s ICL sets the boundary between your Medicare Part D plan’s Initial Coverage Phase and the Donut Hole or Coverage Gap. The ICL is measured by the total retail value of your prescription drug purchases. You can contact American Senior Benefits for detailed information on the Medicare Advantage plans that have an increased or decreased Initial Coverage Limit.

Your Medicare Plan’s Cost-Sharing Can Vary Significantly Between “Preferred” and “Standard” Network Pharmacies

Year-over-year, certain stand-alone Medicare prescription drug plans (PDPs) will use different cost-sharing for preferred vs. standard network pharmacies. As an example, your plan might have a co-payment of $0 for a Tier 1 medication at preferred network pharmacies and, for the same Tier 1 drug, a $5 co-pay when purchased at a standard network pharmacy.

Your Medicare Advantage plan's Maximum Out-of-Pocket (MOOP) Limit May Change

The Medicare Advantage plan MOOP threshold limits how much you will spend on co-payments and co-insurance for in-network, eligible Medicare Part A and Part B coverage. It can often change year-over-year for plans and it is important to be aware of these changes.

The Bottom Line for Medicare Enrollees

If you decide to stay with your current Medicare Part D or Medicare Advantage plan into next year– AND you understand how your Medicare plan is changing – you do not need to do anything – you will be automatically re-enrolled into your Medicare plan along with any changes your plan is making for the coming year.

If your Medicare plan is being terminated in coming year and you are not merged or “crosswalked” to another Medicare plan, you may be without Medicare plan coverage on January 1st.

We are always happy to clear up any confusion when it comes to these Medicare changes that you should be aware of, so please feel free to reach out whichever way is most preferable for you.