Seniors in The Villages who have a Medicare Advantage (MA) plan should immediately check whether their current plan will be available in 2025, according to Jim Bodenner, president of the Villages Chapter of the National Retirees Legislative Network (NRLN).

“Most of the Medicare Advantage insurance companies who provide MA plans to Villagers have announced they will drop over 1 million enrollees across the nation,” Bodenner said. “This is why it is important for seniors here to determine whether their plan will end on December 31, 2024, or continue in 2025.”

According to Bodenner, Humana has told investors that the company expects to lose about 560,000, about 10% of its MA enrollees next year after it exits 13 unprofitable markets and trims its plan options. CVS Health Aetna will force 420,000 members to find other coverage. Centene – Wellcare announced in August it will be ending plans which will impact roughly 37,000 enrollees. Up to 5,395 Cigna beneficiaries will have to find new plans. UnitedHealthcare has not announced whether it will drop MA enrollees.

“In addition to dropping enrollees, there have been news reports that MA insurers will be adding or raising premiums and increasing the out-of-pocket amounts due to higher expenses and lower profits as MA plan enrollees get older and have more healthcare costs,” Bodenner said. “If an MA plan is discontinued, it is an opportunity to give thought to whether a person wants to continue in an MA plan or consider original Medicare with a Medigap plan that pays the 20% that Medicare does not cover.”

Bodenner noted that if an individual’s MA plan is going to be dropped at the end of this year, he or she should be sure to obtain a letter or email from his or her MA plan provider that states, as federal law requires, that he or she has a Guaranteed Issue Right (GIR) to get another MA plan or go into original Medicare.

“With a GIR you can acquire an MA plan or enroll in original Medicare, and if you choose, buy a supplement policy (Medigap) to cover the 20% that Medicare does not pay,” Bodenner said. “The GIR provides 63 days after current MA plan coverage ends to obtain other healthcare coverage. The upcoming Medicare Open Enrollment period October 15 – December 7 will be available to enroll in a new plan.”

He added that during the 63-day window, a person age 65 and older cannot be denied for an MA plan or original Medicare with a Medigap plan due to a pre-existing medical condition or face underwriting due to their medical history.

“If your MA plan ends and you do not take action to acquire a different MA plan or enroll in original Medicare you will be automatically enrolled in original Medicare, but without a Medigap plan,” Bodenner said. “Your MA plan that may be ending could have included Medicare Part D for prescription drugs. If so, it would be wise to shop for and purchase a Medicare Part D plan or an MA plan that include Part D coverage.”

He said it is important to keep any letters, notices, or emails from your MA plan stating that your plan will be discontinued. You may need the information to prove your coverage ended to gain a GIR.

“The NRLN wants to hear from Villagers whose MA plan provider is discontinuing their plan and has not notified them about their GIR,” Bodenner said. “Send an email to [email protected] with the name of your MA plan insurance company and whether it is an HMO or PPO.”

Bodenner noted that the NRLN website at www.nrln.org has video to assist anyone who wants to shop for a Medigap plan on www.medicare.gov and soon there will be a video on how to shop for an MA plan.

“The NRLN wants to help Villagers get the healthcare coverage that is right for them at the best price,” Bodenner said. “Ask your friends to sign up for the Villages Retirees Chapter at https://nrln.org/2021/01/email- sign-up/ to stay informed on this MA issue and other issues important to retirees.”