By Sara Duris
It is time to review your Medicare coverage and compare your options. Medicare Open Enrollment begins October 15 and runs through December 7, 2025. The State Health Insurance Assistance Program (SHIP, formerly known as MMAP) offers trained and certified volunteer counselors to assist in looking at health insurance options.
Area Agency on Aging (AAA) and SHIP counselors offer free and confidential assistance comparing Medicare Advantage plans and Part D drug plan options. SHIP counselors are available throughout our service area of 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 call 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 won’t offer extra benefits like gym membership or transportation any longer.
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% more in costs to Advantage plans compared to the traditional program. An increased aging population with more health issues, along with recent legislative and administrative changes, is responsible for increasing costs.
According to a recent article in US News & World Report, all these factors have placed pressure on the insurers to change offerings, and they have responded by reducing their availability, changing the amount they pay for various drugs, or by cutting out some of the perks. Even those without Advantage plans are likely to see increases. Premiums for Medicare Part B, covering such things as doctor’s visits and other medical services, are set to go up in 2026 as well. The projected increase is for the monthly premium to move from $185 to $206.50. Surcharges for those with higher incomes are also likely to be increased.
The Inflation Reduction Act passed during the Biden Administration also introduced a cap on out-of-pocket expenses for prescription drugs which, in turn, lowered payments to the insurers. Many have reacted by adjusting what drugs they put into their drug formulary and the various tiers for payment.
Everyone on a Medicare Advantage Plan should have received their Annual Notice of Change (ANOC) by now and it is important to review it for premium increases, changes in medications covered, and network updates which indicate if your doctor is still included in the plan. These changes can often be hard to notice, so it pays to check every prescription drug that you currently use each year during Open Enrollment.
Q. I have had insurance with Meridian Complete for the last three years, but I heard it is ending in 2026. What sort of health insurance is going to be available to me?
A. It is true that two dual coverage (combining Medicare and Medicaid) plans, Aetna Better Health and Meridian Complete, are no longer going to be offered in our area through what was called the MI Health Link system. All current enrollees should have received a letter from the Department of Health and Human Services announcing this and that MI Health Link is changing to a new program called MI Coordinated Health (MICH) on January 1, 2026.
MI Coordinated Health is a specific type of Medicare Advantage plan known as a Highly Integrated Dual Eligible Special Needs Plan (HIDE SNP.) This means it is a plan that is designed to meet the needs of those dually eligible for 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. Help in the home 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.
Those individuals currently enrolled with Meridian Complete or Aetna Better Health will hear from their current health plan regarding which HIDE SNP they will be offering and how to 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, choose 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. The Generations column appears each weekend in The Herald-Palladium.