Major shifts are taking place across the Medicare Advantage market. A recent Becker’s Payer Issues report states Humana expects to exit certain plans. This move will impact nearly 600,000 members. According to their 2nd quarter earnings report United Healthcare lost 965,000 Medicare Advantage members. At the same time, Devoted Health is expanding to 5 new states (now 34 total) and adding service to 342 new counties (5 new in Indiana).
This news highlights a vital truth about Medicare. Your coverage changes often, making annual reviews essential to protect your health and budget.
What Is Happening in the Market?
Insurance carriers face rising costs and shifting federal funding rates. In response, major insurance companies are adjusting their plan options.
Carriers are trimming underperforming plans instead of keeping the exact same options everywhere. They may pull out of specific counties entirely. They might also adjust benefits and doctor networks within existing plans.
This reflects a broad trend across the entire healthcare landscape.
Why “Setting and Forgetting” Is Risky
It is natural to stay with a plan you like. However, assuming your coverage stays identical every year can cause expensive surprises. Even if your plan remains available, carriers update details annually:
- Doctor Networks: Hospitals, clinics, and doctors can leave a network.
- Prescription Formularies: Co-pays and coverage rules for your medications often change.
- Out-of-Pocket Limits: Deductibles and maximum out-of-pocket costs adjust regularly.
- Extra Benefits: Allowances for dental and over-the-counter items frequently shift.
Doing nothing could mean getting automatically reassigned to an unfitting plan.
What If Your Plan Is Discontinued?
Federal safeguards protect you if your carrier exits your area. You will receive an official notification letter in the fall. You will also get a Special Enrollment Period. This window lets you pick a new plan without losing coverage.
You do not need to panic, but taking action is necessary.
Your Annual Checkup with KSS Insurance
Industry news should prompt preparation rather than fear. Fall Open Enrollment exists so you can re-evaluate your options smoothly.
At KSS Insurance, we track carrier shifts across Indiana, Georgia, North Carolina, and Florida. As independent agents, we work directly for you.
When Medicare plans shift, we help you:
- Verify Doctor Access: Ensure your trusted physicians stay in-network.
- Review Drug Lists: Cross-reference daily medications against updated plan rules.
- Compare Local Options: Side-by-side plan reviews guarantee optimal value.
Keep Your Coverage Simply Secure
You never have to navigate policy changes alone. When your Annual Notice of Change arrives this fall, let’s connect. We will keep your health coverage simply secure. Schedule a meeting today!