Your Medicare Part D or Medicare Advantage plan can change every year and your Medicare plan is required to summarize any
plan changes in your Annual Notice of
Change letter (ANOC) that you should receive in the mail late-September or
early-October. If you have not received your plan’s ANOC letter,
please call your plan’s Member Services department and ask for another copy of the ANOC - the toll-free telephone number for Member Services can be found on your Member ID card.
What year-to-year changes can you expect in your Medicare Part D or Medicare Advantage plan? Here are a few example:
- Monthly plan premiums can increase (or decrease) (for example, increasing from $44 to $55 per month),
- Initial drug deductibles can increase (for example, increasing from $480 to $505),
- Initial coverage limits, for example the standard ICL is increasing from $4,430 to $4,660. This is the maximum retail value of your medications before entering the Donut Hole when you get a 75% discount on all formulary drugs,
- Prescription drugs that are covered by your plan (the size of the plan's formulary and changes in coverage of specific brand-name and generic drugs - for example, your Tier 1 generics may be moved to Tier 2 Non-Preferred Generics),
- Drug coverage costs or cost on each formulary tier (what you pay for your drugs - such as a $5 co-pay or 25% co-insurance),
- Drug usage management restrictions (for example, does your drug now have a Quantity Limit or require Prior Authorization?),
- Pharmacy networks (usually a Medicare drug plan will expand their pharmacy network each year and may change standard or preferred pharmacies),
- Healthcare provider networks (for Medicare Advantage plans doctors or specialists can be added - or removed from your plans "in-network" coverage),
- Co-payments for medical treatment (for Medicare Advantage plans your healthcare costs can change year-to-year), and
- Your Medicare Advantage plan’s Maximum Out-of-Pocket (MOOP) spending limit for in-network, eligible Medicare Part A and Part B coverage..
Important: Studies show that most people (about 70%) do not change their Medicare
Part D or Medicare Advantage plan each year, even if they can save money on
their prescription and medical costs - and we can appreciate that, for some
people, the value of consistency outweighs the potential for savings - however, we want to remind you that, if you decide to stay with your current
Medicare plan into next year, your Medicare plan coverage and costs can change,
so please take time to know how your current Medicare plan is changing next year.
- How might your Medicare plan change next year and how many people will be affected by the change? See our example for 2023: Q1News.com/978
Bottom Line: If you do not enroll into a new
Medicare Part D plan or Medicare Advantage plan during the
annual Open Enrollment Period (or a
Special Enrollment Period), you will be automatically
re-enrolled into your current Medicare Part D or Medicare Advantage plan for
another year and your Medicare plan next year may cost you more money and provide different
coverage than are finding this year. If your current Medicare plan is being terminated next year and you are
not merged or “
crosswalked” to another Medicare plan, you
may be without Medicare plan coverage on January 1
st.
The Good News: After receiving your ANOC letter in September or early-October, you will have plenty of time to
review your Medicare plan coverage options during the annual Open
Enrollment Period that begins every year on October 15
th and continues through
December 7
th.
Need a fast way to see how your Medicare Advantage or
Medicare Part D plan is changing next year?
Our
PDP-Compare
and
MA-Compare
tools allow you to compare changes in
all stand-alone Medicare Part D
prescription drug plans (PDPs) or Medicare Advantage plans (MAs or MAPDs)
across the country.
Our comparison tools show changes in monthly premiums
and plan designs, as well as changes in co-payments or co-insurance rates for
different drug tiers.
Both the PDP-Compare and MA-Compare tools also show the
Medicare Part D plans or Medicare Advantage plans that will be discontinued or
added next year. The MA-Compare tool includes links to the health coverage
details of all Medicare Advantage plans.
Example of PDP-Compare - Showing how stand-alone Medicare Part D plans can change year-to-year.
Example of MA-Compare - showing how Medicare Advantage plans can change year-to-year.