ARE WE READY FOR MORE CHANGES THIS YEAR...
Another year has come and gone, and it feels like it's passing by quicker and quicker. Each year I send out what I try to make a quick note with what Medicare looks like for the coming year. This year is no different. While not everyone embraces technology, me being one, this seemed a little more interactive, fresh, and a quick way to change information as it changes and get out more lengthy messages than years before. I am attempting to incorporate more forms of communication for the coming year. I would love to gather an updated e-mail address for you to send out updates and reminders. I promise I won't send out too much but just maybe a Happy Birthday or important Medicare updates should I need to get that out on a mass platform UPDATE YOUR EMAIL HERE. I have also included a spot to update any other contact information that may have changed since the last time we spoke.
2026 is going to bring about some big changes. Just how big? Some changes we might possibly not know until as late as November. I will update any information I receive right here and also on my FACEBOOK if you Facebook, follow me if you don't already! With these changes to Medicare being a little bigger, a little more talked about in the news that usually brings about a little more confusion. Because of that, I wanted to outline the coming year a little more in-depth and hopefully leave the confusion out. This is why you find yourself here, reading this the way we used to read menu at a restaurant during Covid. The changes will affect everyone a little differently, maybe some more positivity than others. That's why you have me. We are here to navigate these changes together. This form of communication in no way replaces face-to-face contact, a phone call to chat, or a quick text. I love hearing from all of you and being able to update you on my life, my boys, and more importantly how I can help you. Similar to last year I will not be visiting East Tennessee as much as years prior, times have certainly changed. Now two little guys depend on me. I do have great agents in that area if meeting face-to-face is a desire of yours, please let me know and I will get you in contact with one of those guys.
With housekeeping and catching up out of the way, let's get to the good stuff...
Those currently on Medicare Supplements, sometimes called MediGap plans, could possibly see double digit increases this year. Hopefully, not across the board, but I suspect that it will be the norm. We need to be prepared with our budget in mind for what makes sense for your particular medical needs. We will see the steepest increases on Plan F Supplement Plans, followed by the most common now, Plan G Supplement Plans. Plan N Supplement Plans are usually the most unaffected by steep increases, but I could stand corrected this year. It's important to remember, when your plan increases, I am not given notice. When you receive that notice, getting in contact with me is key. We can't fix something and come up with a game plan if we aren't working together. Another important thing to keep in mind is Medicare Supplements are not locked into the Annual Enrollment Period for changes, we can change this anytime throughout the year. What we do have to do during this time is move to another TYPE of plan, such as a Medicare Advantage Plan. So, to summarize this, increases are coming they are possibly going to hurt, and we can move these plans to another carrier WITH medical underwriting at any time throughout the year.
The Part D Deductible will increase from $590 to $615 annually, it’s important to remember that NOT all plans have this, but instead to keep in mind that this is the maximum allowable deductible a plan can have. Usually, we see this deductible applied to higher tiers of medications on many plans. The Part D maximum out-of-pocket will increase by $100 as well, from $2,000 to $2,100. The $35 insulin cap will continue, and no deductible is applied to this. Zero cost-sharing will also continue for adult vaccines through a beneficiaries Part D coverage (as a stand-alone plan or a Medicare Advantage plan). It appears that several carriers are keeping their inexpensive plans as non-agent(non-commissioned) plans this year. It also appears I'll keep putting folks on them as long as they continue to offer inexpensive coverage that meets your needs. Should I see anything that looks alarming, plan specific information will be updated on or around October 1st.
In Medicare Advantage news, we will see some of the “extra” benefits included in many of the plans change. We have been informed that CMS has really cracked down on these items or services that do not meet, "the standard of having a result in improving or maintaining the health or overall function of the beneficiary." So, this means some of the utility benefits, grocery benefits that were included in some of the Special Needs Plans might change or go away completely. Over the counter benefits on all plans could also be affected. Again, I will update this on or around October 1 should I see any major changes, good or bad. You might receive a Medicare Advantage termination letter, or a non-renewal notice for 2026, it could even just be something stating that your plan is ending for 2026. This is a great time to explore other options; don't worry I will walk you through every step. It actually opens up the opportunity for other types of coverage that you might not have been eligible for before.
It's not all bad news. Several of the Medicare Advantage Plans are changing for the better. I have seen several very popular plans decrease their monthly cost and increase their benefits. Stay tuned for those updates, again on or around October 1st, I'll share anything exciting or frightening. You should receive your annual notice of change (ANOC) in the coming weeks, and it will compare the changes from 2025 to 2026 line by line. You usually will also get notice if a medication you are currently taking is changing on your plan’s formulary. Just like years prior expensive Medications always need to be looked at a little closer to make sure we are exactly where we need to be or at least picking the lesser of two evils.
Something NEW and EXCITING, as exciting as Medicare news can really be. Recently, I completed contracting and training for a new product. It’s something I have been reluctant to market in years prior but have found a company that seems to make the claims process simple, and I have had several “Guineapigs”, including making myself one, that have given me great feedback and rave reviews. The company is not new, it's been around for much longer than I have, but they have revamped their plans, processes, and also made some changes to their claims process which was my biggest concern. These plans are designed as a supplement to Medicare Advantage plans or traditional Health Insurance for someone under 65. They can be designed individually based on your current plan design. It’s a great “filler” option for someone finding their hospital co-pays to be something that might keep them up at night, or ambulance co-pays, etc. We can design plans as low as $20 a month and as I mentioned can be centered around concerns you might have with any significant holes in your coverage. These types of plans pay directly to the beneficiary and not to a facility or doctor so it's something that can be a safety net should you find yourself admitted to the hospital, having an outpatient surgery, having PT, or looking at being placed in a Skilled Nursing Facility following a surgery or hospital stay of some type. In addition to these types of plans, we can always look at cancer or accident policies. I have recently discovered how much it costs to fight cancer, luckily not firsthand, but watching a very close friend of mine recently diagnosed brain cancer. She has been going back and forth to Vanderbilt from East Tennessee for treatment and it's been an expensive journey, even with GREAT insurance covering her medical bills. Cancer plans pay the beneficiary directly so it can be used for any type of expenses, most people assume later in life these plans aren't affordable. I have worked with a great carrier to design a CANCER PLAN that has great coverage as well reasonable cost. If you have been cancer free for at least 5 years you are eligible for this plan, so cancer survivors, don't count yourself out!
To quickly summarize the long-winded explanation of 2026, things are going to change, as they always do. We can navigate those changes by working together and finding what works best for you and what doesn't. The phone calls should ease up a little bit this year as those large call centers just lost a HUGE lawsuit. They are still calling, they are still sending out mail, they are still confusing the masses. Don't get stuck on something we can't fix, Medicare will NEVER call you, Social Security will also never call without a scheduled appointment. The marketplace also does not call either, if you have recently turned 65 and you previously had coverage there. I am currently working towards a Registered Social Security Advisor (RSSA) endorsement but it's a lengthy process I am hoping to become a slightly more well versed in Social Security to be able to provide a little more insight when problems arise with Social Security. They are two very different beasts. In addition to throwing all this new information your way, I have also put a link to a book that I wrote, MEDICARE. MADE EASY., it's a quick, cliff-note guide full of general Medicare information. If you would like a hard copy, let me know.
Finally, I hope everyone is doing well and I always look forward to hearing from everyone. I have built a strong client base, and I cannot thank you enough for continuing to trust me and your continued support through all of the changes the last 12+ years. As I continue to grow and life continues grow more and more chaotic please know I'm still never too busy for our chats and your updates. My cell phone number remains the same, 423-330-4394, make sure to leave a voicemail and give me at least 24 hours to get back with you. I hope 2026 brings you and your family health, happiness, and just pure enjoyment.
