Maine is statistically the “oldest” state in the nation, so it’s not surprising that more than a quarter of its population is enrolled in Medicare, with more joining every year.

But Medicare plans are not as streamlined as the program’s singular name. As annual enrollment for 2025 gets underway, Maine residents who want a Medicare Advantage plan could have 55 options to choose from depending on their county.

With yearly changes that could affect all aspects of a plan, it is imperative that all Medicare beneficiaries read their Annual Notice of Changes (ANOC) carefully to see what it may mean for them.

More about the ANOC letter

This fall, you should have received an ANOC letter from your existing plan’s administrator. It is an intimidating-looking document, but it’s a must-read. You need to know if a required medication will have a higher tier copayment or that your beloved doctor is no longer accepting your plan.

Typical information in your ANOC letter may include changes to:

• Premium, deductible, copays/coinsurances
• Provider Network
• Formulary (list of covered drugs)
• Out-of-pocket maximum
• Prior authorization requirements
• Managed care and referrals
• Covered/included benefits

Unfortunately, ANOCs for many plans will include price increases across the board: costs for premiums, deductibles, copays/coinsurances and prescriptions are going up for many plans for several reasons.

Why are costs increasing?

Medicare is funded by your own payroll taxes withheld for at least 10 years, and by the interest of two trust funds the federal government holds for specific benefits.

Market performance over the past few years is just a small part of the cost increase story. Policy changes from the Inflation Reduction Act that are meant to cap drug prices have resulted in the health care industry seeking sustaining income from other sources. Then, average prices for medications, medical materials, devices and facility fees have all increased, brought on by national and global supply chain and market forces. Last, there is the workforce shortage that Maine patients feel most acutely when trying to get an appointment.

Over the last five years in the state, the number of practicing doctors, nurses, nurse practitioners and other health professionals declined 4.2%, according to federal labor statistics. Workforce disruptions could also affect billing, insurance, and payment processing, not to mention janitorial, laundry, or transportation services. Because of these labor shortages, top-notch, hands-on care and quick responses about your medical bills and finances have become harder to find than ever.

An annual tradition of changes

Each year, the process of Medicare’s annual enrollment is a time to evaluate what has changed about the economy, health care policies, and your personal health and wellness needs. If your existing Medicare Advantage plan is changing, it’s time to do your own research and meet with a Medicare specialist for additional support. A specialist will strain through the alphabet soup of plans, take your needs and concerns into account, and help prioritize the “must-haves” for your health care plan choice in the coming year.

The Martin’s Point Generations Advantage team offers free events and seminars, in-person and online, to help learn more about their Medicare Advantage plan options. Sign up at MartinsPoint.org.