Is your Medicare Advantage plan about to get more expensive? Here’s what to know
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If you rely on a Medicare Advantage plan for coverage beyond the basics—like dental, vision, or even that gym membership—you may want to prepare for some changes ahead.
These all-in-one plans have become increasingly popular among older adults for their added perks and convenience.
But with rising enrollment and new legislation impacting insurance payouts, many plans are beginning to scale back or raise costs.
Whether you're already enrolled or considering your options, it’s more important than ever to stay informed.
Here's what’s driving the changes and what it could mean for your health coverage in 2025 and beyond.
Medicare Advantage (also known as Medicare Part C) now covers more than 54% of Medicare enrollees, up from 37% in 2018.
These plans have attracted millions with their bundled approach, covering things like prescription drugs, dental, vision, and wellness benefits—features not included in traditional Medicare.
But the rapid growth in enrollment has put pressure on insurers.
According to the Medicare Payment Advisory Commission, Medicare is paying about 20% more per enrollee in Advantage plans compared to traditional Medicare.
To manage these rising costs, insurers are beginning to cut back on coverage, limit the availability of certain plans, or eliminate popular extras like gym benefits and enhanced drug coverage.
The Inflation Reduction Act introduced several cost-saving reforms for beneficiaries, including a cap on out-of-pocket drug costs.
While this is great news for older adults, it also means insurers receive less reimbursement for prescription coverage.
In response, many plans are shifting medications to higher tiers, increasing co-pays, or removing drugs from their formularies altogether.
Even outside of Advantage plans, Medicare Part B premiums are projected to rise—from $185 to $206.50 per month by 2026.
Those with higher incomes may face even larger premium surcharges, further adding to the cost burden for some retirees.
In short, you may pay more and receive fewer benefits.
Medicare Advantage plans may see higher monthly premiums, increased co-pays, and reduced access to perks like dental and vision.
Even those on traditional Medicare should expect rising costs.
Fortunately, the Medicare open enrollment period—from October 15 to December 7—gives you the opportunity to review your current plan, compare options, and switch if needed.
Given the shifting landscape, it’s critical to read every notice your plan sends and verify that your doctors, prescriptions, and key benefits are still covered.
As enrollment grows and federal payouts tighten, insurers will likely continue adjusting their plan offerings.
Some plans may be discontinued altogether, while others may offer fewer benefits in exchange for lower premiums.
Flexibility and attention to detail will help you stay ahead of the curve.
Read next: A new bill could save 700,000 seniors from lifelong Medicare penalties—here’s what’s at stake
Have your premiums gone up? Have you lost access to certain providers or benefits? Share your experience in the comments—your story could help others make a more informed decision this enrollment season!
These all-in-one plans have become increasingly popular among older adults for their added perks and convenience.
But with rising enrollment and new legislation impacting insurance payouts, many plans are beginning to scale back or raise costs.
Whether you're already enrolled or considering your options, it’s more important than ever to stay informed.
Here's what’s driving the changes and what it could mean for your health coverage in 2025 and beyond.
Changes to Medicare Advantage plans could affect coverage and out-of-pocket costs in the coming year. Image Source; YouTube / WCNC.
Why Medicare Advantage plans are getting more expensive
Medicare Advantage (also known as Medicare Part C) now covers more than 54% of Medicare enrollees, up from 37% in 2018.
These plans have attracted millions with their bundled approach, covering things like prescription drugs, dental, vision, and wellness benefits—features not included in traditional Medicare.
But the rapid growth in enrollment has put pressure on insurers.
According to the Medicare Payment Advisory Commission, Medicare is paying about 20% more per enrollee in Advantage plans compared to traditional Medicare.
To manage these rising costs, insurers are beginning to cut back on coverage, limit the availability of certain plans, or eliminate popular extras like gym benefits and enhanced drug coverage.
Also read: Why reviewing your Medicare plan every year could save you money and stress
Legislative changes are also playing a role
The Inflation Reduction Act introduced several cost-saving reforms for beneficiaries, including a cap on out-of-pocket drug costs.
While this is great news for older adults, it also means insurers receive less reimbursement for prescription coverage.
In response, many plans are shifting medications to higher tiers, increasing co-pays, or removing drugs from their formularies altogether.
Even outside of Advantage plans, Medicare Part B premiums are projected to rise—from $185 to $206.50 per month by 2026.
Those with higher incomes may face even larger premium surcharges, further adding to the cost burden for some retirees.
Also read: 600,000 UnitedHealthcare Medicare Advantage members to lose coverage in 2025
What this means for you
In short, you may pay more and receive fewer benefits.
Medicare Advantage plans may see higher monthly premiums, increased co-pays, and reduced access to perks like dental and vision.
Even those on traditional Medicare should expect rising costs.
Fortunately, the Medicare open enrollment period—from October 15 to December 7—gives you the opportunity to review your current plan, compare options, and switch if needed.
Given the shifting landscape, it’s critical to read every notice your plan sends and verify that your doctors, prescriptions, and key benefits are still covered.
Also read: Could you be charged extra for Medicare without realizing it?
Tips for navigating the changes
- Review your plan annually – Don’t auto-renew. Coverage, formularies, and provider networks can change year to year.
- Open every letter – Insurers are required to notify you of any changes. Read those notices carefully.
- Compare your options – Use Medicare.gov, talk with a licensed advisor, or consult your local State Health Insurance Assistance Program (SHIP).
- Consider your health needs – If you take multiple medications or manage chronic conditions, make sure your plan still meets your care requirements.
- Don’t be afraid to ask questions – Help is available. Contact a trusted Medicare counselor or a senior resource group for guidance.
Also read: Could Medicare be expanding? Here’s what the new "Part E" proposal might mean for you
What’s ahead for Medicare Advantage?
As enrollment grows and federal payouts tighten, insurers will likely continue adjusting their plan offerings.
Some plans may be discontinued altogether, while others may offer fewer benefits in exchange for lower premiums.
Flexibility and attention to detail will help you stay ahead of the curve.
Read next: A new bill could save 700,000 seniors from lifelong Medicare penalties—here’s what’s at stake
Have your premiums gone up? Have you lost access to certain providers or benefits? Share your experience in the comments—your story could help others make a more informed decision this enrollment season!
