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2025 State of Medicare Address: What You Need to Know

Medicare is Changing—Are You Prepared?

Medicare is experiencing some of the biggest shifts in decades, and not all of them are positive. The Inflation Reduction Act (IRA), shifting government policies, and decisions by insurance companies are disrupting coverage, raising costs, and cutting access to trusted advisors.

At NUMA, we are committed to helping and protecting you when life gets complicated. That’s why we traveled to Washington, D.C., met with Congress members and Medicare policy leaders, and analyzed every change coming in 2025.

The bottom line?
📉 Medicare is not being cut, but how it works is changing dramatically.
💰 The $2,000 prescription drug cap is helpful for some, but premiums, deductibles, and plan structures are shifting in response.
🔍 Insurance companies are removing agents, reducing support, and shifting financial burdens to you.

In this comprehensive State of Medicare Address, we’ll break down:
✅ What’s changing in 2025
✅ How it affects you (even if you don’t take medications!)
✅ How NUMA is fighting for you
✅ Why Medicare is getting more confusing—just when you need help the most
✅ What you MUST do before April 15 to protect yourself

Meet the NUMA Team—We’re in This Together

Before diving into the serious Medicare changes, we took a moment to celebrate some personal milestones.

Suzanne McClain

• “I’ve been helping clients with Medicare for over 15 years, and many of you have been with me since the beginning. You’ve watched my kids grow up! My oldest son got married last September, and my youngest is graduating from Ohio State in May. It’s been an emotional year!”

Joe McClain

• “We recently went on a family cruise with our son, Mitchell, as a graduation gift. It was a great time to reconnect before he starts a new chapter.“

Tisha 

• “Big news—I just got approved for a home loan! We’re actively looking for the right house. It’s been a journey, but we’re excited about what’s ahead!”

Alice

• “I just returned from a family trip to Hawaii. My entire family—kids, spouses, and grandkids—all traveled back home to see my parents. It was the first time in years we were all together.”

Brittany

• “We bought 3.5 acres of land and are getting ready to build a house! Between that and raising two kids, life has been busy.”

Ty

• “Not much going on in my life—except I fixed my car’s radiator and water pump all by myself! And hey, I got a nice tax return, so that was a bonus!”

Why does this matter? Because Medicare is personal—it affects real people, real families, and real lives. We’re not just a company; we’re a team that genuinely cares about helping you navigate these changes.

Medicare in 2025: The Good, The Bad, and The Ugly

The Good News: A $2,000 Cap on Drug Costs

Starting January 1, 2025, no Medicare beneficiary will have to pay more than $2,000 per year for covered prescription drugs. This eliminates the “donut hole” where many seniors had to pay 25% of their medication costs out-of-pocket.

Sounds great, right? But there’s a catch…

The Bad News: Higher Premiums, Lost Medications, and Insurer Bailouts

💡 Only 16% of Medicare beneficiaries actually hit the $2,000 drug cap. The remaining 84% will likely see higher premiums to compensate for insurance company losses.

💡 Insurance companies are scrambling to adjust—and they’re making changes behind the scenes:

• Raising premiums significantly
• Dropping expensive medications from coverage
• Moving commonly used drugs into higher-cost tiers
• Imposing new deductibles (up to $590 on some plans!)

💡 In response to industry complaints, the government gave insurers a 1-year bailout to help offset these changes. But what happens when that expires in 2026? Expect even bigger disruptions next year.

The Ugly Truth: Advisors Are Being Cut Out

🚨 The Day WellCare Insurance Abandoned Over 1,000 NUMA Clients

I’ll never forget the moment we found out. WellCare Insurance had decided to cut all agents from their Medicare plans—without warning, without explanation. Over 1,000 of our clients were suddenly left without the support they’d always relied on.

I was furious. We had spent years helping people navigate these plans, making sure they were on the best options for their needs, and now? WellCare was telling them: “You’re on your own.”

They did it for one reason—money. By cutting agents, they could keep more profits for themselves, but the ones who really suffered? Our clients.

Even though we were no longer allowed to sell or service WellCare plans, we made a decision—we would still tell our clients about them if they were the best option for their prescriptions. Because at the end of the day, this business isn’t about commissions. It’s about doing what’s right.

Since last summer, many other insurance companies have followed suit, cutting commissions on certain plans, nothing that was as bad as WellCare has taken place… yet. 

🚨 We were told to STOP doing annual reviews at a Medicare conference in Washington, D.C

We sat there in stunned silence. A woman—a high-ranking executive at a major Medicare agency—looked out at a room full of agents and said:

“I wish all of you would stop doing annual reviews for your clients.”

I couldn’t believe what I was hearing. She was telling people to cut the service to their clients—to let them figure it out on their own—just to cut costs and save time.

This is what the Medicare industry is becoming—a race to the bottom. Agencies want to see how little service they can provide while still making money.

That’s not us. That’s not NUMA.
That's NOT Helping and Protecting others when Life gets Complicated!

We will never go against our God-Given Mission to Help and Protect others, especially when life gets complicated. Because Medicare is complicated, and people deserve someone in their corner.

Medicare is getting more complicated every year.
Without professional guidance, seniors risk:
❌ Overpaying for the wrong plan
❌ Losing access to their doctors or medications
❌ Getting stuck with billing errors 

Why NUMA is Standing Firm—And Fighting for You

Unlike other agencies, we refuse to abandon our clients. That’s why we launched the ExtraCare Membership, ensuring you still get the support and protection you need.

What You Get with Extra Care Membership

✅ Annual Medicare Plan Review – Ensures you have the best plan for your needs every year.

✅ Billing Advocate Services – We fight incorrect bills and get errors fixed.

✅ Unlimited Phone & Email Support – Have a question? We’re here year-round to help.

✅ Secure Online Portal – Easily update doctors and prescriptions for personalized plan reviews.

✅ Live Event Access – A free ticket for you and a friend to our annual Medicare event.

✅ Legacy of Love Kit – A step-by-step guide to organizing your estate and passwords to avoid headaches for your family.

How to Enroll in ExtraCare

***Due to industry changes, we can’t continue offering annual reviews for free.***

To lock in NUMA’s support, you must enroll in ExtraCare before April 15, 2025.

✅ Each Grandfathered client pays just $59.99 per year (or $5.99/month) per person.
✅ If you miss the deadline you will pay the new client price of $199 per year per person.
✅ This is a per person price: Each person must enroll individually.

***You will NOT receive an annual Medicare review unless you are enrolled in ExtraCare.***

How to Enroll in Extra Care

 🖥️ Click the link and enroll securely online. https://numedicareadvisors.com/extracare-gf/
📞 Prefer to enroll by phone? Call NUMA, and we’ll sign you up over the phone. (614) 448-1834

Final Thoughts:

Can You Afford the Cost of “Free”? A Real Medicare Story

It was just a few weeks ago when Tisha, one of our Medicare advisors, sat down with a new client and his wife. They were going through our Medicare JOY Process, discussing plans, coverage, and what the best options were for their situation.

As Tisha explained our NUMA Extra Care Membership, the husband listened carefully but then asked, “Can’t you just put my wife on the same $5 plan I have?”

That’s when the truth hit.

Tisha looked at him and said, “Well… you don’t have a $5 plan anymore.”

The husband blinked in confusion. “What do you mean? I’ve been paying $5.30 a month for my prescription drug plan.”

He had no idea that his plan had changed.

A Year Ago: A Decision That Cost Him Hundreds

Rewind to last year’s Medicare Open Enrollment. His wife wasn’t yet eligible for Medicare, but he was. At that time, we had reviewed his options and told him about our NUMA Extra Care Membership, which provides an annual plan review to ensure clients are always on the best coverage.

But he wasn’t convinced.

Another advisor told him they could help him for free—no extra fees, no membership costs, just “free service.” It sounded good to him at the time, so he went with that other advisor instead.

What he didn’t realize was that “free” service came with a hidden cost: neglect.

When Open Enrollment came around again, his advisor didn’t call. Didn’t check his plan. Didn’t alert him to the changes.

And that $5.30 plan? It had jumped to over $40 per month.

By the Time He Found Out, It Was Too Late

Because no one reviewed his plan, he missed the window to switch to a better option. That meant he was now locked in for the entire year at the new, higher rate.

He pulled out a calculator. $40 per month, compared to the $5 he was used to paying.

The difference? An extra $420 for the year.

The “Free” Service Cost Him More Than Double What Our Membership Would Have

As reality sank in, he shook his head and sighed. “So… if I had just paid the $199 for your membership, I would have saved money?”

Tisha nodded. “Yes. We would have reviewed your plan, seen the increase, and found a lower-cost option. That’s exactly why we do these reviews.”

It was a hard lesson learned. The truth is, when it comes to Medicare, what you don’t know can cost you—sometimes hundreds or even thousands of dollars.

Your cost for ExtraCare is only $59.99 per year, per person.
NOT $199/yr that New NUMA Clients pay.

 🖥️ Click the link and enroll securely online. https://numedicareadvisors.com/extracare-gf/

📞 Prefer to enroll by phone? Call NUMA, and we’ll sign you up over the phone. (614) 448-1834

Would You Walk Across the Street for $1,600?

I was sitting with one of my long-time clients, going through his annual Medicare review. We’d done this every year, and he always came in prepared, confident that his coverage was just fine.

“Everything's working perfectly, Suzanne,” he told me with a smile. “I don’t need to change anything.”

I nodded. “That’s great! But let me just run the numbers for you, double-check your plan, and make sure there aren't any cost-saving opportunities.”

He agreed, though he was absolutely certain nothing would change.

But that’s when I saw something.

I looked up at him and said, “Well, I don’t need to change your insurance company. I don’t need to change your plan. I don’t even need to change the medications you’re taking.”

His smile grew. “Told you.”

I smiled back. “But… if you switch your pharmacy from the one you’re using now to the one across the street, you’ll save $1,600 this year.”

His jaw dropped.

The Hidden Costs of Convenience

Like so many people, he had been using the same pharmacy for years. It was familiar, it was close, and he never thought to check if another pharmacy just a few minutes away might have lower prices.

But here’s the thing about Medicare prescription drug plans: different pharmacies have different pricing agreements with insurance companies. 

And in his case, simply filling his prescriptions at a preferred pharmacy instead of a standard pharmacy would save him $1,600 a year.

I leaned in and asked, “Would you be willing to walk across the street for sixteen hundred dollars?”

His eyes widened. “I’d run across the street for that!”

This Is Why We Do Reviews Every Year

This client was not taking any new medications. He was on the same plan. He had the same insurance.

But without this review, he never would have known he was overpaying by more than a thousand dollars—just because of where he was filling his prescriptions.

This is why we fight so hard to do these reviews for our clients. Medicare is complicated, and insurance companies don’t go out of their way to tell you where you can save money.

That’s why we do.

Could You Be Overpaying?

When we run Medicare reviews, we don’t just check your plan—we check everything, including pharmacy pricing.

Because sometimes, all it takes is walking across the street to put hundreds (or thousands) of dollars back in your pocket.

Your cost for ExtraCare is only $59.99 per year, per person.

 🖥️ Click the link and enroll securely online. https://numedicareadvisors.com/extracare-gf/

📞 Prefer to enroll by phone? Call NUMA, and we’ll sign you up over the phone. (614) 448-1834

📆 Deadline: April 15, 2025 📆

🔹 Your Medicare deserves expert guidance.
🔹 Your peace of mind is worth it.
🔹 NUMA is here to help &  protect you for the duration of your Medicare Journey

Enroll now and secure your support for 2025 and beyond! 🚀

We love serving you!

Suzanne, Joe, Tisha, Alice, Brittany and Ty