If you’re on a Medicare Advantage plan, you may be tempted to toss aside the lengthy letter that you should have gotten by now that explains changes to your plan for the coming year. But it pays to read it this year.
Numerous changes are coming to Medicare in 2025 that may affect you. While plans may change every year, 2025 introduces new limits for drug pricing, which can have a knock-on effect on other Medicare Advantage components. Depending on your plan and where you live, your costs, covered medications, provider network, extra benefits, and plan availability may be different next year. These should all be outlined in your letter, and you can use it to help you decide whether you want to switch or drop your plan during Medicare open enrollment, which runs between Oct. 15 and Dec. 7.
Whether you’re enrolled in a Medicare Advantage plan, a Medicare Advantage Special Needs Plan, or a group-based Medicare Advantage plan, you should have received your ANOC letter in September by mail or email. It should also be available on your provider’s website. (If you haven’t yet received it, contact your provider.)
"I always encourage people to look at the ANOC notice, but often, their eyes glaze over because it's 15-25 pages long," said Mary Jane Harris of Independent Medicare Advisors in St. Louis, Missouri. Harris doesn’t sell insurance but does advise Medicare recipients on plans. "This year, even if you've never done it, you must do it."
You might notice changes in costs or benefits, such as those that provide prepaid debit cards that can be used for eligible over-the-counter (OTC) purchases. "Your OTC card that used to give you $200 a month may now only give you $25 per month to spend. Maybe your gym membership reduces from $600 worth of annual coverage to $100," said Harris. Copays may go up from $20 to $25, and your maximum out-of-pocket (MOOP) limits are essential to review, too.
Other surprises could include drugs not being covered and changes in physician networks. Even in Harris's city of St. Louis, some large hospital systems are threatening to withdraw from specific Medicare Advantage plans in 2025, citing lower reimbursements and administrative paperwork hassles.
Medicare Advantage plans combine Medicare Part A, Part B, and, usually, Part D into one plan that offers hospital, physician, equipment, and drug coverage. Many plans also provide extra benefits for vision and dental care.
Your Medicare Advantage letter typically features five to seven parts, including:
Here are the particular changes to look out for as you review your ANOC letter.
Your costs will likely change in 2025. "Medicare Advantage enrollees are looking at increases in premiums, deductibles, copays, and coinsurance," Harris said.
So, review your:
Here’s what we know so far about average costs.
| National Average Medicare Advantage Costs | |||
|---|---|---|---|
| Cost | 2024 | 2025 | Difference |
| Avg. Monthly Medicare Advantage Premium | $18.23 | $17.00 | -$1.23 (-6.75%) |
| Avg. Monthly Premium, Drug Plan With Medicare Advantage | $15.56 | $13.50 | -$2.06 (-13.2%) |
| Avg. Annual Drug Deductible, Drug Plan With Medicare Advantage* | $146.37 | $306.10 | +$159.73 (109%) |
| Avg. Max Out-of-Pocket Limit (MOOP), In-Network, All MA Plans* | $5,473.13 | $5,929.47 | +$456.34 (+8.3%) |
| Avg. MOOP, In-Network, MA Plans With Drug Coverage* | $5,462 | $5,852.15 | +389.98 (+7.1%) |
*Source: Investopedia analysis of 2024 and 2025 landscape files from the Centers for Medicare & Medicaid Services (CMS), not weighted by enrollment. All other rows of data in this table come from CMS and are weighted by predicted enrollment figures.
According to a 2024 CMS report, around 60% of Medicare Advantage enrollees will have a premium of $0 in 2025. About 83% of enrollees will have the same or lower premium if they stay with the same plan, and around 20% will see reduced premiums.
But these averages can shift at the state level. Here’s a sample list of states to illustrate.
| State-Level Avg. Medicare Advantage Premiums | |||
|---|---|---|---|
| State | 2024 Premium | 2025 Premium | Difference |
| Florida | $10.09 | $4.33 | -$5.76 (-57.0%) |
| Texas | $9.15 | $6.81 | -$2.34 (-25.6%) |
| California | $16.25 | $12.48 | -$3.77 (-23.2%) |
| North Carolina | $16.27 | $18.81 | +$2.54 (+15.6%) |
| Louisiana | $18.86 | $23.46 | +$4.6 (+24.4%) |
| New York | $30.35 | $42.90 | +$12.55 (+41.4%) |
As you can see, premiums increased in North Carolina, Louisiana, and New York while decreasing in Florida, Texas, and California.
The ANOC summarizes your plan's significant changes. Look for coverage and cost changes for Medicare-covered services like emergency, psychiatric, skilled nursing facility care, and durable medical equipment (DME) supplies. You can see your complete list of costs in a separate Evidence of Coverage document, and it never hurts to refamiliarize yourself with any costs.
The average monthly Medicare Advantage (MA) plan premium will be $17.00 in 2025. However, you will also need to pay your Part B premium, deductibles, copays and coinsurance for care and services, up to the plan’s out-of-pocket maximum.
Most Medicare Advantage enrollees opt for an MA plan that includes Part D prescription medication coverage. If you get drugs through your Medicare Advantage plan, consult the Pharmacy Directory to ensure your preferred pharmacies are in-network and that you understand the 2025 changes coming to your drug plan.
To accurately review your drug costs, review both your ANOC letter and the List of Covered Drugs your plan offers. In 2025, the drug-coverage “donut hole” will disappear and be replaced with a flat $2,000 maximum out-of-pocket cap for drug costs.
In brief, review:
Your plan could also move drugs to a different cost-sharing tier, remove or add medications to the formulary, or change coverage restrictions.
Some plans update the drug list monthly but are generally required to give you plenty of advance notice if removing a drug.
The CMS said Medicare Advantage extra benefits will be stable in 2025. It notes that 99% of Medicare Advantage plans will offer vision coverage, while 97% will offer hearing and dental supplemental benefits.
Other Medicare Advantage plan benefits sometimes include quarterly or annual pre-loaded cards for buying over-the-counter health items and coverage for routine acupuncture and chiropractic care.
However, your Medicare Advantage benefits could change in 2025. Experts have warned that insurers may reduce coverage and increase costs of extra benefits in response to other changes happening to Medicare in 2025. This could even happen for people on Special Needs Plans (SNP).
Examples of benefit changes might include:
If you’re a Medicare Advantage enrollee who needs coverage while traveling, pay close attention to any increases in the copayments for worldwide emergency or urgent care coverage.
Your Summary of Benefits contains a full list of your extra benefits. A new rule requires your plan to send you a personalized letter regarding your benefits in mid-2025. The letter will detail all supplemental benefits you haven’t used in the first six months of 2025, provide more information about the benefits in question, and explain how you might use those benefits.
Plans may change hospitals, doctors, and pharmacies in your network. Review your plan’s 2025 Provider Directory to ensure your primary care provider, specialists, and hospitals are in-network for the upcoming year.
Harris uses a product to help beneficiaries find plans that specifically meet their needs—from drug to specialist coverage. "If you live near a heart hospital but it's not in your plan network, it's not helpful," Harris said.
Your plan’s directory will likely be online and offer information on in-network primary care providers, medical groups, community and health clinics, specialists, and other facilities. You should be able to see the number of in-network doctors available to you within a specified distance and whether the provider is accepting new, existing, or no patients.
If a specialty is listed—such as acupuncturists—but doesn’t offer in-network specialists, this could be a red flag.
In 2025, you can enroll in the new Medicare Prescription Payment Plan (MPPP). This program spreads your drug payments over the year, with amounts that vary.
If you enroll, you don’t pay when at the pharmacy. Instead, you pay a monthly bill your plan sends. Learn more about a payment plan by visiting your plan’s website, calling your plan, or calling or visiting Medicare.gov.
Most Medicare Advantage plans offer drug coverage, which will significantly change in 2025. Changes to Part D require plans to be more responsible for improving drug-cost management while making out-of-pocket drug costs more reliable and limited for beneficiaries.
You can compare Medicare Advantage plans and switch to a new Medicare Advantage plan. But in some cases, you may be forced to do so. In Texas, the 381 Medicare Advantage plans in 2024 were reduced to 373 Medicare Advantage plans in 2025, and in Louisiana, beneficiaries could choose from 112 plans in 2024 but now have 99 plans in 2025.
If your Medicare Advantage plan isn’t renewing its Medicare contract for 2025, it should have notified you in writing by October 2, 2024. This notification allows a switch to a new Medicare Advantage plan or Original Medicare with Medicare Supplement (Medigap) coverage.
"We already know that several MAPD plans are being terminated for 2025," said Lori Howell of Howell Medicare Advisors, a fee-only Medicare advisory service. "One subject that people don't talk about enough is that if your MAPD plan is terminated, your options for new coverage may be limited."
If you're on a plan that's ending, you're usually automatically enrolled in another plan offered by your current insurance company. But don't rely on the company to ensure your medications and pharmacies are covered with the new plan, Harris said.
"The beneficiary can be automatically enrolled in another plan that may not have all of their medications in the new plan's formulary," Harris warned. If a beneficiary ignores notification of the change and new plan enrollment, "They may not know that the plan no longer meets their needs and may be stuck for a year."
A plan’s written discontinuation offers you a Special Enrollment Period for a Medicare Supplement plan. However, you must get the written letter before pursuing the Medigap plan.
If you qualify for a Special Needs Plan (SNP), be aware that more SNP plans will be available for those with chronic or special health conditions. Enrollment will grow to 7.2 million in 2025 and around 28% of Medicare Advantage enrollees will be in MA SNP plans.
Reviewing 2025 changes is particularly important if you're the adult child of a Medicare Advantage enrollee who cannot review the fine print, calculate cost changes, or manage the network, authorization, and referral requirements.
"I see people in memory care, and nobody looks at their ANOC, then next year when the plan changes, the adult children are surprised when mom's doctor isn't in-network anymore," said Harris.
Adult children should figure out their parents' plans, then read the letter, and look up or help the parent review the information online. It should be online by Oct. 15, when Medicare open enrollment starts every year. Medicare Advantage plan recipients can also change plans between January and March during Medicare Advantage Open Enrollment.
Many younger people don't understand Medicare's fine print because they are familiar with employer-based coverage, which tends to remain fairly consistent year over year.
The design of the Medicare Advantage program means that plans constantly change, and not always to the benefit of plan enrollees.
"There's only so much money to go around, and insurance companies will want to make a profit, and more of a profit every year,” Harris said. “No matter how much Medicare gives them to run the plans, they'll spend what they have to and keep what they can."
This could include minor changes in dozens of ways—some so small you may not notice at first and others more jarring immediately. If necessary, you may need to shop for a new Medicare Advantage plan.
With the proliferation of plans, "sometimes Medicare Advantage is more like the cereal aisle," Harris said. "You know there's something out there for you. But the aisle is a mile long, with surprise ingredients that can overwhelm you."
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