UnitedHealthcare Adjusts Medicare Advantage Plans Following Inflation Reduction Act Provisions

UnitedHealthcare Enhances Medicare Advantage Offerings for 2025

UnitedHealthcare is adjusting Medicare Advantage plans in response to the Inflation Reduction Act (IRA) regulations. Starting in 2025, deductibles will be introduced in certain Part D formulary tiers impacting how beneficiaries pay for medications. The aim is to manage overall drug costs while keeping copays manageable for tier 1 and tier 2 drugs, which comprise nearly 90% of claims for Medicare Advantage Prescription Drug members.

Key Changes in Medicare Part D

• Introduction of deductibles for certain formulary tiers.
• Implementation of the smoothing plan allowing monthly payments for high-cost drugs.
• $2,000 cap on out-of-pocket costs set to take effect.

Expanding Medicare Advantage Options

In addition to updates in Part D, UnitedHealthcare plans to expand its offering with 140 new Medicare Advantage plans. This includes:

1. Creation of more Dual Special Needs Plans (D-SNPs) to serve additional dual-eligible individuals.
2. Expansion of Chronic Special Needs Plans (C-SNPs) for beneficiaries with severe chronic conditions.
3. Launch of CareFlex plans offering financial credits for out-of-pocket costs.

The Inflation Reduction Act changes are significant as they aim to shift more drug costs to plans, affecting the overall landscape of Medicare drug coverage.