Thinner benefits and coverage changes await many older Americans shopping for health insurance this fall. That’s if their plan is even still available in 2025.
More than a million people will probably have to find new coverage as major insurers cut costs and pull back from markets for Medicare Advantage plans, the privately run version of the federal government’s coverage program mostly for people ages 65 and older.
Industry experts also predict some price increases for Medicare prescription drug plans as required coverage improvements kick in.
Voters will learn about the insurance changes just weeks before they pick the next president and as Democrat Kamala Harris campaigns on promises to lower health care costs. Early voting has already started in some states.
“This could be bad news for Vice President Harris. If that premium is going up, that’s a very obvious sign that you’re paying more," said Massey Whorley, an analyst for health care consulting company Avalere. "That has significant implications for how they’re viewing the performance of the current administration."
Insurance agents say the distraction of the election adds another complication to an already challenging annual enrollment window that starts next month.
Medicare Advantage plans will cover more than 35 million people next year, or around half of all people enrolled in Medicare, according to the federal government. Insurance agents say they expect more people than usual will have to find new coverage for 2025 because their insurer has either ended a plan or left their market.
The health insurer Humana expects more than half a million customers — about 10% of its total — to be affected as it pulls Medicare Advantage plans from places around the country. Many customers will be able to transfer to other Humana plans, but company leaders still anticipate losing a few hundred thousand customers.
CVS Health’s Aetna projects a similar loss, and other big insurers have said they are leaving several states.
Insurers say rising costs and care use, along with reimbursement cuts from the government, are forcing them to pull back.
When insurers leave Medicare Advantage markets, they tend to stop selling plans that have lower quality ratings and those with a higher proportion of Black buyers, said Dr. Amal Trivedi, a Brown University public health researcher.
He noted that market exits can be particularly hard on people with several doctors and on patients with cognitive trouble like dementia.
Most markets will still have dozens of plan choices. But finding a new option involves understanding out-of-pocket costs for each choice, plus figuring out how physicians and regular prescriptions are covered.
“People don’t like change when it comes to health insurance because you don’t know what’s on the other side of the fence,” said Tricia Neuman, a Medicare expert at KFF, a nonprofit that researches health care.
Plans that don’t leave markets may raise deductibles and trim perks like cards used to pay for utilities or food.
Those proved popular in recent years as inflation rose, said Danielle Roberts, co-founder of the Fort Worth, Texas, insurance agency Boomer Benefits.
“It’s really difficult for a person on a fixed income to choose a health plan for the right reasons … when $900 on a flex card in free groceries sounds pretty good,” she said.
Prices also could rise for some so-called standalone Part D prescription drug plans, which people pair with traditional Medicare coverage. KFF says that population includes more than 13 million people.
The Centers for Medicare and Medicaid Services said Friday that premiums for these plans will decrease about 4% on average to $40 next year.
But brokers and agents say premiums can vary widely, and they still expect some increases. They also expect fewer plan choices and changes to formularies, or lists of covered drugs. Roberts said she has already seen premium hikes of $30 or more from some plans for next year.
Any price shift will hit a customer base known to switch plans for premium changes as small as $1, said Fran Soistman, CEO of the online insurance marketplace eHealth.
The changes come as a congressional-approved coverage overhaul takes hold. Most notably, out-of-pocket drug costs will be capped at $2,000 for those on Medicare, an effort championed by Democrats and President Joe Biden in 2022.
In the long run, these changes will lead to a “much richer benefit,” Whorley said.
KFF's Neuman noted that the cap on drug costs will be especially helpful to cancer patients and others with expensive prescriptions. She estimates about 1.5 million people will benefit.
To ward off big premium spikes because of the changes, the Biden administration will pull billions of dollars from the Medicare trust fund to pay insurers to keep premium prices down, a move some Republicans have criticized. Insurers will not be allowed to raise premium prices beyond $35 next year.
People will be able to sign up for 2025 coverage between Oct. 15 and Dec. 7. Experts say all the potential changes make it important for shoppers to study closely any new choices or coverage they expect to renew.
“This is not a year to sleep on it, just re-enroll in the status quo,” said Whorley, the health care analyst.
The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group. The AP is solely responsible for all content.
The Medicare website is seen on a computer in New York on Thursday, Sept. 26, 2024. (AP Photo/Rachel Leathe)
PERRY, Fla. (AP) — Hurricane Helene caused dozens of deaths and billions of dollars of destruction across a wide swath of the southeastern U.S. as it raced through, and more than 3 million customers went into the weekend without any power and for some a continued threat of floods.
Helene blew ashore in Florida's Big Bend region as a Category 4 hurricane late Thursday packing winds of 140 mph (225 kph) and then quickly moved through Georgia, the Carolinas and Tennessee, uprooting trees, splintering homes and sending creeks and rivers over their banks and straining dams.
Western North Carolina was essentially cut off because of landslides and flooding that forced the closure of Interstate 40 and other roads. Video shows sections of Asheville underwater.
Francine Cavanaugh said she has been totally unable to reach her sister, son, or friends in the Asheville area.
“My sister checked in with me yesterday morning to find out how I was in Atlanta,” she said on Saturday. “The storm was just hitting her in Asheville, and she said it sounded really scary outside.”
Cavanaugh said her sister had no idea how bad the storm would be there. She told Cavanaugh she was going to head out to check on guests at a vacation cabin “and that’s the last I heard of her. I’ve been texting everyone that I know with no response. All phone calls go directly to voicemail.”
She saw video of a grocery store near the cabins that was completely flooded.
“I think that people are just completely stuck, wherever they are, with no cell service, no electricity.”
There were hundreds of water rescues, none more dramatic than in rural Unicoi County in East Tennessee, where dozens of patients and staff were plucked by helicopter from the roof of a hospital that was surrounded by water from a flooded river.
The storm, now a post-tropical cyclone, was expected to hover over the Tennessee Valley on Saturday and Sunday, the National Hurricane Center said. Several flood and flash flood warnings remained in effect in parts of the southern and central Appalachians, while high wind warnings also covered parts of Tennessee and Ohio.
Among the at least 44 people killed in the storm were three firefighters, a woman and her 1-month-old twins, and an 89-year-old woman whose house was struck by a falling tree. According to an Associated Press tally, the deaths occurred in Florida, Georgia, North Carolina, South Carolina and Virginia.
In the wealthy enclave of Davis Islands in Tampa, where star athletes like Derek Jeter and Tom Brady have lived, residents were continuing to clean up Saturday from storm surge left by Helene.
The neighborhoods that sit just off Tampa’s downtown and are home to about 5,000 people had never seen storm surge like it had Friday. No one died, but homes, businesses and apartments were flooded.
”I don’t think anybody was expecting it,” Faith Pilafas told the Tampa Bay Times. “We’ve kind of gotten accustomed to lots of talk about big storms, and never actually like feeling the effects of it. So for all the people who didn’t leave the island, I feel like they were all just expecting it to be a normal storm, anticlimactic. And wow, were we surprised.”
Authorities warned residents to evacuate, and many did, but some stayed behind.
In North Carolina, a lake featured in the movie “Dirty Dancing” overtopped a dam and surrounding neighborhoods were evacuated, although there were no immediate concerns it would fail. People also were evacuated from Newport, Tennessee, a city of about 7,000 people, amid concerns about a dam near there, although officials later said the structure had not failed.
Tornadoes hit some areas, including one in Nash County, North Carolina, that critically injured four people.
Atlanta received a record 11.12 inches (28.24 centimeters) of rain in 48 hours, the most the city has seen in a two-day period since record keeping began in 1878, Georgia’s Office of the State Climatologist said on the social platform X. Some neighborhoods were so badly flooded that only car roofs could be seen poking above the water.
Moody’s Analytics said it expects $15 billion to $26 billion in property damage.
Climate change has exacerbated conditions that allow such storms to thrive, rapidly intensifying in warming waters and turning into powerful cyclones sometimes in a matter of hours.
Florida's Big Bend is a part of the state where salt marshes and pine flatwoods stretch into the horizon, and where the condo developments and strip malls that have carved up so much of the state's coastlines are largely absent.
It’s a place where Susan Sauls Hartway and her 4-year-old Chihuahua mix Lucy could afford to live within walking distance of the beach on her salary as a housekeeper.
At least, until her house was carried away by Helene.
Friday afternoon, Hartway wandered around her street near Ezell Beach, searching for where the storm may have deposited her home.
“It’s gone. I don’t know where it’s at. I can’t find it,” she said of her house.
The community has taken direct hits from three hurricanes since August 2023.
All five who died in one Florida county were in neighborhoods where residents were told to evacuate, said Bob Gualtieri, the sheriff in Pinellas County in the St. Petersburg area. Some who stayed ended up having to hide in their attics to escape the rising water. He said the death toll could rise as crews go door-to-door in flooded areas.
More deaths were reported in Georgia and the Carolinas, including two South Carolina firefighters and a Georgia firefighter who died when trees struck their trucks. Virginia Gov. Glenn Youngkin reported at least one death in his state.
President Joe Biden said he was praying for survivors, and the head of the Federal Emergency Management Agency headed to the area. The agency deployed more than 1,500 workers, and they helped with 400 rescues by late Friday morning.
Officials urged people who were trapped to call for rescuers and not tread floodwaters, warning they can be dangerous due to live wires, sewage, sharp objects and other debris.
In Georgia, an electrical utility group warned of “catastrophic” damage to utility infrastructure, with more than 100 high voltage transmission lines damaged. And officials in South Carolina, where more than 40% of customers were without power, said crews had to cut their way through debris just to determine what was still standing in some places.
The hurricane came ashore near the mouth of the Aucilla River, about 20 miles (30 kilometers) northwest of where Hurricane Idalia hit last year at nearly the same ferocity. Florida Gov. Ron DeSantis said the damage from Helene appears to be greater than the combined effects of Idalia and Hurricane Debby in August.
The destruction extended far beyond Florida.
A mudslide in the Appalachian Mountains washed out part of an interstate highway at the North Carolina-Tennessee state line.
Another slide hit homes in North Carolina and occupants had to wait more than four hours to be rescued, said Ryan Cole, the emergency services assistant director in Buncombe County. His 911 center received more than 3,300 calls in eight hours Friday.
“This is something that we’re going to be dealing with for many days and weeks to come,” Cole said.
Forecasters warned of flooding in North Carolina that could be worse than anything seen in the past century. The Connecticut Army National Guard sent a helicopter to help.
Helene was the eighth named storm of the Atlantic hurricane season, which began June 1. The National Oceanic and Atmospheric Administration has predicted an above-average season this year because of record-warm ocean temperatures.
Payne reported from Tallahassee, Florida, and Hollingsworth reported from Kansas City, Missouri. Associated Press journalists Seth Borenstein in New York; Jeff Amy in Atlanta; Russ Bynum in Valdosta, Georgia; Danica Coto in San Juan, Puerto Rico; Andrea Rodríguez in Havana; Mark Stevenson and María Verza in Mexico City; and Claire Rush in Portland, Oregon, contributed.
Vehicles move slowly around trees that have fallen after of Hurricane Helene moved through the area, Friday, Sept. 27, 2024, in Valdosta, Ga. (AP Photo/Mike Stewart)
Vehicles move slowly around trees that have fallen after Hurricane Helene, Friday, Sept. 27, 2024, in Valdosta, Ga. (AP Photo/Mike Stewart)
Torrential rain from Hurricane Helene has caused lake levels to rise on Lake James, resulting in flooded docks and gazebos, Friday, Sept. 27, 2024 in Morganton, N.C. (AP Photo/Kathy Kmonicek)
Hailey Morgan, right, surveys the damage to their flooded home after returning with her children, Aria Skye Hall, 7, left, and Kyle Ross, 7, in the aftermath of Hurricane Helene, Friday, Sept. 27, 2024, in Crystal River, Fla. Morgan stayed with her grandmother and her children in Hernando, Fla., as the storm made landfall. (AP Photo/Phelan M. Ebenhack)
Destruction to the Faraway Inn Cottages and Motel is seen in the aftermath of Hurricane Helene, in Cedar Key, Fla., Friday, Sept. 27, 2024. (AP Photo/Gerald Herbert)
A caravan of Army vehicles make their way through a street flooded by the passing of Hurricane John, in Acapulco, Mexico, Friday, Sept. 27, 2024. (AP Photo/Bernardino Hernandez)
An airboat transports residents rescued from floodwaters in the aftermath of Hurricane Helene on Friday, Sept. 27, 2024 in Crystal River, Fla. (Luis Santana/Tampa Bay Times via AP)
Leslie Sturmer, a University of Florida employee, and John Rittenhouse, general manager of the Cedar Key Water and Sewer District, both residents, talk in the aftermath of Hurricane Helene, in Cedar Key, Fla., Friday, Sept. 27, 2024. (AP Photo/Gerald Herbert)
Foundations and steps to buildings that were destroyed by the storm surge from Hurricane Helene are seen along the shoreline in the aftermath of the storm, in Cedar Key, Fla., Friday, Sept. 27, 2024. (AP Photo/Stephen Smith)
A damaged 100-year-old home is seen after an Oak tree landed on it after Hurricane Helene moved through the area, Friday, Sept. 27, 2024, in Valdosta, Ga. (AP Photo/Mike Stewart)
Thomas Chaves, left, and Vinny Almeida walk through floodwaters from Hurricane Helene in an attempt to reach Chaves's mother's house in the Shore Acres neighborhood Friday, Sept. 27, 2024, in St. Petersburg, Fla. (AP Photo/Mike Carlson)
This photo provided by Venice Police Department rescue crews assist residents after conducting door-to-door wellness checks, in coastal areas that were flooded by Hurricane Helene on Friday, Sept. 27, 2024 in Venice, Fla . (Venice Police Department via AP)
Residents work together to push a vehicle stuck on a street flooded by the passing of Hurricane John, in Acapulco, Mexico, Friday, Sept. 27, 2024. (AP Photo/Bernardino Hernandez)
Capt. BJ Johnston, a law enforcement officer from the Florida Fish Wildlife and Conservation Commission surveys destruction from a high water buggy in the aftermath of Hurricane Helene, in Cedar Key, Fla., Friday, Sept. 27, 2024. (AP Photo/Gerald Herbert)
A dog wades through floodwaters near collapsed homes in Dekle Beach on the coast of rural Taylor County, Fla., Friday, Sept. 27, 2024. (AP Photo/Kate Payne)
This satellite image from the National Oceanic and Atmospheric Administration taken at 6:11pm ET shows Hurricane Helene, which weakened into a post-tropical cyclone, over the United States on Friday, Sept. 27, 2024. (NOAA via AP)
A Citrus County Firefigher carries 11-year- old, Michael Cribbins, while conducting rescues from floodwaters in the aftermath of Hurricane Helene on Friday, Sept. 27, 2024 in Crystal River, Fla. (Luis Santana/Tampa Bay Times via AP)
MJ Hodges, left, and her mother Jill Rice look at the damage caused to their store from the floodwaters of Hurricane Helene on Friday, Sept. 27, 2024, in Gulfport, Fla. (AP Photo/Mike Carlson)
Dustin Holmes, rear, his girlfriend Hailey Morgan, and her children Aria Skye Hall, 7, left, and Kyle Ross, 4, right, arrive to their flooded home in the aftermath of Hurricane Helene, Friday, Sept. 27, 2024, in Crystal River, Fla. (AP Photo/Phelan M. Ebenhack)
This photo provided by U.S. Coast Guard District Seven (USCGSoutheast) shows a man and his dog being rescued after his sailboat became disabled during Hurricane Helene approximately 25 miles off Sanibel Island, Fla., on Thursday, Sept. 26, 2024. (U.S. Coast Guard District Seven via AP)
Dustin Holmes, second from right, holds hands with his girlfriend, Hailey Morgan, while returning to their flooded home with her children Aria Skye Hall, 7, right, and Kyle Ross, 4, in the aftermath of Hurricane Helene, Friday, Sept. 27, 2024, in Crystal River, Fla. (AP Photo/Phelan M. Ebenhack)
Destruction to the Faraway Inn Cottages and Motel is seen in the aftermath of Hurricane Helene, in Cedar Key, Fla., Friday, Sept. 27, 2024. (AP Photo/Stephen Smith)
Jill Rice looks over the damage to her store caused by flooding from Hurricane Helene on Friday, Sept. 27, 2024, in Gulfport, Fla. (AP Photo/Mike Carlson)
