Did you hear about the changes to Medicare Advantage?

 

Changes are coming to Medicare Advantage Plans and Prescreption Drug Plans. 

The final rule for Medicare Advantage and Part D prescription drug plans for 2025 was issued by the Centers for Medicare & Medicaid Services (CMS) in April 2024 [4]. It's important to note that this is the final rule, not a proposed rule.

Here are some of the key changes implemented for 2025:

• Increased focus on behavioral health: The rule aims to improve access to behavioral health services by including them in the standards for adequate supplemental benefits offered by Medicare Advantage plans [4].
• Standardized compensation for brokers: The rule caps and standardizes how much Medicare Advantage plans can compensate brokers for enrolling beneficiaries, aiming to prevent biased enrollment practices [4].
• Protection of beneficiary data: The rule limits how much personal information of beneficiaries can be shared by third-party marketing organizations [4].
• Streamlined enrollment process: The enrollment process is simplified for individuals who are eligible for both Medicare and Medicaid (dually eligible) [4].
• Review of utilization management: Medicare Advantage plans will undergo annual reviews to ensure their utilization management practices consider health equity [4].
• Additionally the changes also focus on
• Behavioral Health: Increased access to mental health and addiction treatment services is a likely focus.
• Medicare Advantage Changes: Expect updates on plan offerings, cost-sharing, and marketing practices.
• Part D Prescription Drug Plans: Look for adjustments to medication coverage and potential cost changes.
• Telehealth Expansion: The final rule may extend waivers allowing for more telehealth services.
• Payment Updates: Physician reimbursement rates and hospital outpatient payments could be adjusted.

To find out what this means for you click here and a licensed agent will be in contact.