Should You Review Your Medicare Plan in 2025 for the Upcoming 2026 Plan Year
- Reese Phillips II
- Aug 4
- 4 min read
As the leaves begin to fall and the temperatures cool down, many seniors start thinking about their health insurance for the coming year. Taking the time to review your Medicare plan can be vital in making sure you have the right coverage for your needs. But is it really necessary to revisit your Medicare plan in 2025 for the 2026 plan year? Let’s dig into this important question and highlight the factors you should consider.
Understanding the Importance of Reviewing Your Medicare Plan
Medicare is a significant health insurance program serving seniors and certain disabled individuals. It consists of various parts, including Medicare Part A (hospital insurance), Part B (medical insurance), Part C (Medicare Advantage), and Part D (prescription drug coverage). Knowing how each part works is essential when reviewing your options, especially since changes can occur frequently.
Regularly reviewing your Medicare plan means you’re being proactive about your healthcare. This becomes especially important if your health needs change or you face new medical challenges. For example, you might find that:
Some critical services aren’t included in your current plan, like physical therapy or mental health support.
Your medications could be listed on a different tier in the drug formulary, leading to higher out-of-pocket costs if you’re on Medicare Part D.
Monthly premiums might go up by as much as 10%, while benefits stay the same.
New Medicare Advantage plans may offer additional benefits that fit your lifestyle better, such as gym memberships or transportation services to medical appointments.
Choosing the right plan can help you feel less stressed about healthcare costs and possibly save you money over time.
Essential Factors to Consider When Reviewing Your Medicare Plan
As you prepare to review your Medicare plan in 2025, keep these factors in mind:
Changes in Health Condition: If your health has changed, your current coverage may not suit your needs anymore. For instance, if you now require medication for diabetes that your current plan doesn’t cover, reassessing your options is crucial.
Plan Changes: Each year, Medicare plans can alter their benefits and premiums. For example, in 2021, over 10 million beneficiaries changed their Medicare Advantage plans due to better coverage options. Reviewing annually keeps you informed about any changes that might affect you.
Drug Coverage: Many people rely on Medicare Part D for medication. Drug formularies can change, which may affect whether your prescriptions are still covered. In fact, approximately 28% of Medicare Part D beneficiaries had plans that changed drug coverage in 2023.
Budget Considerations: As healthcare costs continue to rise, it's essential to review how much you’re spending every month. If your premiums and out-of-pocket costs have increased, there may be alternative plans available that offer better financial options while maintaining quality care.
New Available Plans: Each year, new Medicare Advantage plans can come to your area. A comprehensive review may reveal options with added benefits, such as free annual wellness checkups or expanded dental coverage.
The Benefits of Consulting with Experts
Reassessing your Medicare plan can seem daunting, but you don’t have to tackle it alone. Seeking help from Medicare experts, like those at Preferred Senior Benefits, can provide the guidance you need. Whether you prefer to meet in person, talk over the phone, or chat via video call, specialists can help you navigate the complicated landscape of Medicare.
Consider these advantages of working with Preferred Senior Benefits:
Personalized Evaluation: Experts can take the time to analyze your unique healthcare needs. They can explain which plans would best meet those requirements, ensuring you don’t miss out on essential services.
Comparison of Plans: With so many Medicare plans available, sorting through your options can become overwhelming. Specialists can shed light on the differences, helping you to see which plans truly stand out in coverage and cost-effectiveness.
Continued Support: After you select your plan, ongoing support is available. This means you can easily ask questions and get help for any concerns that may arise throughout the year.
Make an Informed Decision for Your Health
In summary, reviewing your Medicare plan in 2025 for the upcoming 2026 plan year is not just advisable; it’s essential. With factors such as changing health conditions, new plans, and rising healthcare costs, taking a thoughtful approach is key.
Engaging a Medicare consultant can provide the support and resources you need to make the best choices for your health. At Preferred Senior Benefits, we’re ready to help you understand your options and feel confident in your decisions.
Plan ahead and take control of your healthcare future!
About Preferred Senior Benefits in Meridian, Idaho
Medicare is a federal program that provides healthcare coverage to individuals 65 or older. Original Medicare coverage is broken into two parts—Part A and Part B—and is accepted by nearly every doctor and hospital in the country. Medicare Part A covers inpatient or hospital stays, while Part B covers outpatient or medical care. Parts A and B cover about 80% of seniors' typical healthcare costs. This leaves a few significant gaps in coverage. Medicare Supplement (Medigap) and Medicare Advantage plans are policies designed to help extend coverage, lessen costs, and ultimately give beneficiaries peace of mind. If you or someone you know would like more information about how to enroll in Original Medicare or one of the Medicare Advantage plans, call now to speak with a licensed agent (208) 818-2523. We can’t wait to help you learn about your options.