Thousands of Seniors Lose Medicare Coverage After 25% of Plans Leave Oregon

Thousands of seniors are losing their Medicare Advantage coverage next year, and roughly 25 percent of plans are expected to no longer be available in 2025.
Many private insurers are cutting their plans amid rising costs in part due to changes under the Inflation Reduction Act (IRA).
The IRA put pressure on insurance providers by lowering reimbursement rates, causing many insurers to pull out of markets they deem no longer economically viable to operate in. The IRA also introduced prescription drug caps and reduced base payments to Medicare Advantage insurers, creating additional cost concerns.
More From Newsweek Vault: Latest Social Security News: Learn About the 2025 COLA Announcement Date and Upcoming Changes to Your Benefits
In Oregon alone, Moda Health and Summit Health announced they would be ending Medicare Advantage plans next year, and Regence BlueCross BlueShield of Oregon, Aetna and PacificSource will also be closing some plans for seniors on Medicare.
Based on the cuts, more than 12,000 Oregonians will likely need to find a new healthcare plan, according to the Centers for Medicare & Medicaid Services.
Some counties are likely to be more impacted by the changes than others, with Curry, Harney, Lake, Umatilla and Union Counties no longer having any Medicare Advantage plans available. In those areas, seniors will have to choose the original public version of Medicare instead.
More From Newsweek Vault: Online Banks vs. Traditional Banks: Learn the Differences
Other areas, like Coos County, will only have one Medicare Advantage plan to choose in 2025.
Under Regence, HMO (Health Maintenance Organization) plans under Medicare Advantage will no longer be offered in Oregon except in Lane County. Aetna, another major insurer, as well as PacificSource, are also ending plans in the Portland metro area.
More From Newsweek Vault: Best Place to Put Your Benefits: CD vs. High-Yield Savings Account
“The nature of the industry is changing, and many payers are evaluating their Medicare Advantage business in light of these changes and recent plan performance. We’re no different,” Regence said in a statement.
“We regret the impact necessary benefit cuts and plan reductions will have on our members and we’re doing our best to minimize disruptions.”
Seniors affected by the changes should receive a notice of termination and then have time to choose a new plan during the special enrollment period from December 8 through February. Those who want coverage in January, however, need to make their choice by the end of the year.
Otherwise, they will be automatically enrolled in Medicare Part A and B and will need to sign up for prescription drug coverage (Part D) separately.
Louise Norris, a health policy analyst for healthinsurance.org, said that seniors affected must make sure they understand any messages they have received from their insurers and what action they may need to take.
“Enrollees received notifications from their insurer last month about any plan changes for 2025, including coverage terminations,” Norris told Newsweek. “There are a lot of changes this year, so Medicare beneficiaries need to make sure they understand any communications they’ve received from their plan this fall.”
The changes seniors face on Medicare Advantage plans is one significant drawback when it comes to comparing the privatized plans with traditional Medicare, said Chris Fong, a Medicare expert and the CEO of Smile Insurance.
“This is the unfortunate reality with Medicare Advantage plans,” Fong told Newsweek. “They have the potential to have changes and to not be renewed each year. A lot of insurance companies are feeling the financial pressure of lower Medicare reimbursements and the Inflation Reduction Act.”
Due to these financial pressures, smaller insurance companies have terminated several plans as they can’t keep up with higher costs and lower reimbursement rates, Fong said.
“The fear for most people is that they may not know where to turn to for help finding out if their plan is renewing or terminating or navigating the changes for 2025,” Fong said. “My advice is to find a trustworthy and knowledgeable agent for those who are worried about navigating the coverage on their own.”
Alex Beene, a financial literacy instructor for the University of Tennessee at Martin, said the cuts are putting the pressure back on seniors, one of America’s most vulnerable groups.
“No one wants to spend their golden years having to constantly look into new healthcare options, but this is becoming the norm,” Beene told Newsweek. “Seniors will have to do their due diligence to locate a provider that best meets their health conditions and can properly fund any goods and services they may need for care.”