Medicare open enrollment to begin Oct. 15

It is time to review your Medicare coverage and compare your options. Medicare open enrollment begins Oct. 15 and runs through Dec. 7. The State Health Insurance Assistance Program (SHIP, formerly known as MMAP) offers certified and trained volunteer counselors to assist in looking at health insurance options.

Area Agency on Aging (AAA) and SHIP counselors offer free and confidential assistance with comparing Medicare Advantage plans and Part D drug plan options. SHIP counselors are available throughout Berrien, Cass and Van Buren counties. Appointments can be made by calling 269-408-4354. You can also find information about SHIP locations on our website, www.AreaAgencyonAging.org/medicare-medicaid, or by calling our Info Line for Aging and Disability at 800-654-2810.

Q: Is Medicare going to have big cost increases next year? Are Medicare Advantage Plans changing? I read that costs are going up and some will no longer offer extra benefits like gym memberships or transportation.

A: Many of those enrolled in a Medicare Advantage Plan will see changes to their coverage in 2026, including limited "extras" and cost increases. Some will even see their current plan end.

The number of Medicare enrollees in Advantage plans has risen significantly over the last five years. Medicare estimates that it pays 20 percent more in costs to Advantage plans compared to the traditional program. These increasing costs are caused by an increased aging population with more health issues, along with recent administrative and legislative changes.

According to a recent article in US News & World Report, all of these factors have placed pressure on the insurers to change offerings. Insurance companies have responded by reducing their availability, changing the amount they pay for various drugs or eliminating some perks. Even those without Advantage plans are likely to see increases. Premiums for Medicare Part B, covering doctor's visits and other medical services, are set to go up in 2026 as well. The projected increase for the monthly premium is $185 to $206.50. Surcharges for those with higher incomes are also likely to be increased.

The Inflation Reduction Act, passed by the Biden Administration, introduced a cap on out-of-pocket expenses for prescription drugs which, in turn, lowered payments to the insurers. Many companies have reacted by adjusting the drugs included in their drug formulary, as well as the various tiers for payment.

By now, everyone on a Medicare Advantage Plan should have received their Annual Notice of Change (ANOC). It is important to review this document for premium increases, changes in covered medications and network updates, which indicate if your doctor is still included in your plan. These changes can often be hard to notice, so it pays to check every prescription drug that you currently use during each year's open enrollment.

Q: For the last three years, I have had insurance with Meridian Complete, but I heard it is ending in 2026. What sort of health insurance will be available to me?

A: It is true that two dual coverage (combining Medicare and Medicaid) plans, Aetna Better Health and Meridian Complete, will no longer be offered in our area through the MI Health Link system. All current enrollees should have received a letter from the Department of Health and Human Services containing this announcement, including news that MI Health Link will be changing to a new program, called MI Coordinated Health (MICH), starting Jan. 1, 2026.

MICH is a specific type of Medicare Advantage plan known as a Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP.) This means that the plan is designed to meet the needs of those dually eligible for both Medicare and Michigan Medicaid, and will cover all Medicare and Michigan Medicaid benefits through a single Health Plan, including Part D medications, transportation, vision and dental. Participants will have one card for their Medicare and Michigan Medicaid benefits. In-home help is available through Home and Community Based Services (HCBS) for those who qualify. MI Coordinated Health clients will have a Care Coordinator to help manage their care and support needs.

Individuals currently enrolled with Meridian Complete or Aetna Better Health will hear from their current health plan regarding which HIDE SNP will be offered and how they can remain enrolled. All individuals who are eligible to dually receive their Medicare and Michigan Medicaid coverage can choose to enroll in any MICH plan available in their county, opt for another dual Medicare Advantage plan or choose to receive services through original Medicare and Michigan Medicaid. These changes can be made during Medicare open enrollment, as noted above.

Sara Duris is community information liaison of Region IV Area Agency on Aging in Southwest Michigan. Questions on age or independence services? Call the Info-Line for Aging & Disability at 800-654-2810 or visit areaagency onaging.org. The Generations column appears each weekend in The Herald-Palladium.