The Coming Medicare Advantage Shake-Up: Seniors Need to Pay Attention

Big changes are coming to Medicare Advantage plans, and many seniors will be caught off guard if they don’t start paying attention now.

“We have our finger on the pulse of the market, and there are dramatic changes happening,” says Keith Nabb, a Medicare specialist with 31 years of experience and owner of one of the largest Medicare planning agencies in Georgia. His firm, Affordable Medicare Solutions, focuses on educating beneficiaries, helping them select coverage, and then managing their plans year after year.

Those three decades of experience give him a clear view of what he calls a “cascading disruption” in the Medicare Advantage market, much of it linked to the Inflation Reduction Act and recent shifts in Medicare funding.

How We Got Here

The Inflation Reduction Act delivered important relief on prescription drug costs.

“Drug plans went from an $8,000 out‑of‑pocket risk for seniors down to $2,100 this year, and that was a big deal,” Nabb explains.

But that relief came with pressure on the private insurance companies that administer Medicare Advantage plans. According to Nabb, they are now responding with:

• Benefit reductions

• Plan exits from certain counties or markets

• Even mid‑year plan closures, which he describes as “highly unusual”

In Georgia alone, there are about 760,000 Medicare Advantage members, roughly 55% of the Medicare market. One major carrier, Humana, covers about 340,000 of those members.

“Humana’s CEO just announced they were going to have massive benefit reductions and plan exits and changes,” Nabb says. Many of these changes are expected to be announced in the fall and take effect January 1.

The Quiet Disappearance of “Extra” Benefits in Medicare Advantage Plans

For years, Medicare Advantage plans have been allowed—indeed encouraged—to offer extra benefits beyond what Original Medicare covers, such as:

• Dental and vision

• Hearing aids

• Over‑the‑counter (OTC) items like cough medicine, vitamins, and adult diapers

• Healthy food and wellness benefits

“Medicare doesn’t normally cover those things,” Nabb says. “They’ve allowed the Advantage system to do that to give seniors much more robust health care.”

Now, many of those extras are on the chopping block.

“It looks like a lot of those non‑mandatory benefits are getting ready to be greatly reduced or eliminated,” he warns. “A senior might have $2,000 of dental care in their plan. That might go down to just $500 of preventive‑only dental. No fillings, no root canals.”

The result is that many seniors will learn only in January that their dental, vision, or OTC benefits aren’t what they used to be, unless they take action beforehand.

When Seniors Don’t Open Their Mail

On paper, seniors have protections if their Medicare Advantage plan ends. If a plan is canceled, federal law requires the insurer to send a letter explaining that the beneficiary can return to Original Medicare and obtain a Medicare supplement with no health questions.

The problem, Nabb says, is that many people never read the letter.

“How many people open their mail? Very few,” he notes. “Seniors get besieged by all sorts of mail and scams. They just leave it on the counter. They tune it all out, including the important stuff.”

He describes a familiar pattern: “Somebody will call us in January and say, ‘Hey, my plan is not working.’ We tell them, ‘We sent you multiple messages in the fall that your plan was ending.’ The only reason they’re calling is because they went to the doctor and were told, ‘Your plan has ended.’”

If a plan changes but does not end, the member is usually rolled into the new, reduced-benefit version. If a plan ends, the person is often reverted to Original Medicare with no drug coverage or supplemental protection unless they choose new coverage within a limited timeframe.

Under Original Medicare, that can be expensive quickly. “You go into the hospital under Original Medicare, just walking in the door is $1,760, even if you’re just there overnight under observation,” Nabb explains. “That’s up to four times a year. This is why people have Medicare supplements and Medicare Advantage plans—so they don’t have to pay those high costs.”

A National Issue, Not Just Georgia’s Problem

Although he uses Georgia data to illustrate the situation, Nabb stresses this is a national issue. Nationwide, Medicare Advantage enrollment is around 50% of the Medicare population; Georgia is at 55%, “about 10% above the national average.”

Behind the scenes, he points to the math: “Last year, Medicare received a 5% funding increase. This year, it’s going to be 2.48%, but medical inflation is running 7–10%. The dam is breaking where the funding and the inflation don’t match.”

When that happens, plans respond by cutting benefits, exiting markets, or closing plans entirely.

Why Professional Guidance Matters

In this environment, Nabb strongly advises seniors to work with a licensed Medicare professional, not celebrity spokesmen, anonymous 1‑800 call centers, or well‑meaning but under‑trained volunteers.

“Volunteers are just that: volunteers,” he says. “They’re not going to know everything that’s going on. We, on the other hand, have to go through 40–50 hours of training every year on all the different companies, and we meet with carrier reps to get early information.”

“You really want to deal with somebody who is a total nerd and embedded in this system,” Nabb adds. “That’s someone like Affordable Medicare Solutions.”

His core message for seniors and their families is simple: don’t assume your plan will stay the same. Watch your mail, answer calls from trusted professionals, and get your coverage reviewed before the next wave of changes hits.

For more information, visit https://www.affordablemedicaresolutions.com/ or call 770.945.5261.