Is Medicare Advantage going away in 2025?
Asked by: Addie Larson Jr. | Last update: August 26, 2025Score: 4.2/5 (27 votes)
What are the changes to the Medicare Advantage plans in 2025?
Beginning January 1, 2025, people with Part D plans through traditional Medicare and Medicare Advantage plans with prescription drug coverage won't pay more than $2,000 over the calendar year in out-of-pocket costs for their prescription medications.
Why are people leaving Medicare Advantage plans?
But there are trade-offs. Medicare Advantage plans often have a limited network of hospitals and physicians. And while the premiums are typically low, enrollees could end up paying more in the long run in copays and deductibles if they develop a serious illness.
Why are providers dropping Medicare Advantage plans?
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.
Are seniors going to lose Medicare Advantage plans?
Medicare Advantage plans are being impacted all over the country: One analysis estimates that a total of 1.8 million customers will lose their plans next year. In Vermont, MVP and WellCare are dropping two MA plans in January 2025.
How Medicare Drug Coverage Changes Will Impact You in 2025
Why are Medicare Advantage plans being cancelled?
The purpose of insurance companies running Medicare Advantage plans is to make money, pure and simple. Seniors across the country rely on these plans — yet the record shows that insurers don't value the quality and affordability of care, and don't want beneficiaries to use the medical services they need.
How much will Medicare cost in 2025 for seniors?
The standard monthly premium for Medicare Part B enrollees will be $185.00 for 2025, an increase of $10.30 from $174.70 in 2024. The annual deductible for all Medicare Part B beneficiaries will be $257 in 2025, an increase of $17 from the annual deductible of $240 in 2024.
Can I drop my Medicare Advantage plan and go back to original Medicare?
Medicare Advantage Open Enrollment Period: Between January 1 and March 31 of each year, if you already have a Medicare Advantage Plan (with or without drug coverage) you can: Switch to another Medicare Advantage Plan (with or without drug coverage). Drop your Medicare Advantage Plan and return to Original Medicare.
What companies are pulling out of Medicare Advantage plans?
Plan Exits and Closures
Humana, CVS Aetna, and UnitedHealthcare collectively impact over 1.2 million members due to their plan closures. Eighteen marketing brands — including Premera Blue Cross and Blue Cross and Blue Shield of Kansas City — are exiting the market entirely in 2025, affecting tens of thousands of ...
Is Humana pulling out of Medicare Advantage plans?
Humana declined to name the areas; about 560,000 Medicare Advantage beneficiaries impacted. Humana will stop offering Medicare Advantage (MA) in 13 counties in 2025, Humana CFO Susan Diamond said in a published report in Becker's Payer Issues dated Sept.
Who is the largest Medicare Advantage provider?
- UnitedHealthcare is the largest provider of Medicare Advantage plans. ...
- Aetna is a CVS Health company and is the fourth-largest provider of Medicare Advantage plans.
Why do doctors not like Medicare Advantage plans?
Across the country, provider grumbling about claim denials and onerous preapproval requirements by Advantage plans is crescendoing. Some hospitals and physician practices are so fed up they're refusing to accept the plans — even big ones like those offered by UnitedHealthcare and Humana.
Why is a medicare supplement better than an advantage plan?
Consider Original Medicare with a Medigap plan if you:
Original Medicare with a Medigap plan gives you access to any doctor or hospital that accepts Medicare. Intend to travel. Medicare Advantage plans come with limited service areas; if you travel outside, you may have to pay out of pocket for medical care.
What is the highest rated Medicare Advantage plan?
- Humana - Best nationwide availability.
- Anthem - Best for special needs plans.
- Aetna - Best value plans.
- Wellcare - Best health and wellness amenities.
- AARP - Best for veterans.
- UnitedHealthCare - Best for telemedicine care.
- Kaiser - Highest member satisfaction and ratings.
What happens to Medicare in 2026?
For the first time, Medicare is able to negotiate directly with manufacturers for the price of certain high-spending brand-name Medicare Part B and Part D drugs that don't have competition. Prices have been negotiated for the first 10 drugs selected and will be effective in 2026.
How do you qualify for $144 back from Medicare?
- Be enrolled Original Medicare (Parts A and B)
- Pay your own Part B premium.
- Live in the service area of a plan that offers a Part B giveback.
Why are seniors losing Medicare Advantage plans?
Millions of seniors will lose access to their Medicare Advantage plans after major insurer cuts in the aftermath of the Inflation Reduction Act. Experts spoke with Newsweek about what's going on and what steps seniors can take to get the coverage they need.
Is Humana in trouble financially?
Humana shares, among the sector's most hard hit, have fallen nearly 44% so far this year, after the company withdrew its 2025 forecast previously, citing disappointing government Medicare reimbursement rates.
What is the alternative to a Medicare Advantage plan?
A Medigap policy is a supplement to Original Medicare coverage. When you're getting started with Medicare, you can either buy Medigap or enroll in a Medicare Advantage Plan, but you can't have both. You can't buy Medigap while you're in a Medicare Advantage Plan unless you're switching back to Original Medicare.
What is the biggest disadvantage of the Medicare Advantage Plan?
Medicare Advantage Plan Pros And Cons
One disadvantage is that some Medicare Advantage plans may offer fewer options when it comes to doctors and hospitals, as they may have smaller plan networks than Original Medicare.
What is the two midnight rule for Medicare Advantage?
The two-midnight presumption directs medical reviewers to select Original Fee-for-Service Medicare Part A claims for review under a presumption that hospital stays that span two midnights after an inpatient admission are reasonable and necessary Part A payment.
Are there any 5 star Medicare Advantage plans?
The 5-star Special Enrollment Period provides an opportunity for you to switch to a 5-star Medicare Advantage-only plan, a 5-star Medicare Advantage Plan with prescription drug coverage, or a 5-star Medicare Prescription Drug Plan.
Does everyone have to pay $170 a month for Medicare?
Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.
What will Medicare Advantage do in 2025?
Medicare Advantage Highlights for 2025
Nearly one-third (32%) of Medicare Advantage plans will offer some reduction in the Medicare Part B premium in 2025, an increase compared to 2024 (19%). Nearly all Medicare Advantage plans (97% or more) are offering vision, dental and hearing, as they have in previous years.
What does social security extra help pay for?
The Extra Help program helps with the cost of your prescription drugs, like deductibles and copays. You can apply for Extra Help any time before or after you enroll in Part D.