MeadorCare August Newsletter...

Halfway Through the Year: Is Your Health Insurance Still Working for You?

Let's check on you and your families plan, do you anticipate any changes that you didn't plan for when the plan was started?

For example, if someone has to have surgery that was not anticipated when the plan was taken out, can you switch your plan in the middle of the year, how will that effect your MOOP (Max Out of Pocket) and the deductible?

If you are not sure if your plan will continue working for you, or if you want to find out if you should change your plan...guess what you can do, call, or text me. And we can come up with a plan that may save you thousands of dollars (not bad for a single phone call).

stephen@meadorcare.com

5405016767 call or text

Premiums will be heading higher but how much??

At this time, I am going to pull a rabbit out of my hat and try to predict what premiums will look like next year. This is my opinion based on conjecture, industry leaders, trends and other bits I have collected this year.

We will talk about Medicare first, VA Marketplace and Small Group plans.

There is a general trend I have seen on all plan types of plans, probably around 14% - 17% Nationwide. Part B premium around $ 208 for 2027.

1 Medicare Supplements, this can be broken down by the Plan type i.e. Plan G vs Plan N, I thought that Plan N would have a lower increase based on the Birthday Rule in VA but it looks like they amounts are very similar at this point. I would expect a 17% increase on all Med Supps going into 2027. Here is why the MLR (Medical Loss Ratio), they amount they have to spend to pay for claims is too high and if Insurance Companies don't increase premiums they will exit the state, meaning you will have to get a new plan and typically less competition means higher premiums again. This will hopefully be the last of the double digit increase years. You can expect a premium on most drug plans next year as well. Just to break that down, Part B, Med Supp, and Drug plan will likely have increases.

2. Medicare Advantage plans (MAPD or Medicare Advantage Prescription Plans). Premiums should probably stay near 0 or 0. From what I have seen this year will remain stable I anticipate no blowups; a few plans may cancel but for the most part fairly stable. MOOPS, Copays and Coinsurance will stay about the same, I have not heard of any networks changing, so far. I expect to keep the same MOOPs, low OTC, low Dental and copays. However, it looks like next year we may see benefits become richer next year, hang tight this year.

3. VA Marketplace, probably an average increase on premiums of 14% going into 2027. SWVA Marketplace plans are much more limited than plans on the coast of VA (we are kind of used to this kind of treatment). Big news but by this time next year we have gotten the attention of a very large carrier that will enter the whole state, they are aware that you have to have Carilion in network before you enter Roanoke. More competition spreads out risk and can lower premiums; this is my hope.

4.Small Group, more complicated, more options but similar expectation so far. I would expect an increase of around 20% for 2027. I hope I am wrong, we shall see. There are ways to avoid paying more in premium by shifting risk by Self Funding or ICHRA.

We are coming into the 4th Quarter, here's how to prepare for 2027's insurance plan.

Let’s Talk About Your Situation

Depending on the type of coverage you have, here’s what you should be thinking about as we head toward 2027.

1. Medicare

Medicare Supplement, Medicare Advantage (MAPD), and Prescription Drug Plans (PDP)

If you have a Medicare Advantage or Part D drug plan:
You should receive your Annual Notice of Change (ANOC) toward the end of September. Review it carefully to see what is changing for 2027.

1. A. Happy with your plan?
   If your plan still fits your needs for 2027, you may not need to make a change.

2. B. Want a second opinion?
   Schedule a time with us and we can review your coverage, prescriptions, doctors, and benefits to make sure your plan still makes sense.

3. C. Is your plan leaving the area or being discontinued?
   We will need to schedule a time to review replacement options for 2027.

4. D. Is your Medicare Supplement premium getting too high?
   Let’s talk. Depending on your situation, there may be other Medicare Supplement or Medicare Advantage options worth considering.

2. Virginia Marketplace

Individual and Family Health Insurance

If your current coverage is working well and the cost still fits your budget, you may not need to make a major change.

However, we should talk if you want to:

• -Move up or down in metal level

• -Increase benefits or lower your out-of-pocket exposure

• -Reduce your monthly premium

• -Review changes to your doctors or prescriptions

• -See whether a different plan makes more sense for 2027

If your current plan is no longer available, the Marketplace may transition you into another available plan. Don’t assume that automatically selected plan is the right one for you. Schedule a time with us so we can review your options before enrollment ends.

3. Small Group

Employer-Sponsored Health Coverage

For our small-group clients, we want to take a deeper look at your coverage rather than simply accepting another renewal increase.

We’ll review whether we can improve the benefits or lower the cost by looking at options such as:

Traditional Fully Insured • Level Funded • Self-Funded • MEWA • ICHRA

Small Group - Any type

1. We need to review your coverage and see if we can lower the rate by looking at underwriting options, switching plan types, MEWA, Fully Funded, Self Funded or ICHRA. We will reach out to you to go over options.

Expectations for the end of 2026...

A Lot of Change This Year

I think this may end up being a difficult year for many people when it comes to their health insurance. With changes to plans, premiums, benefits, and rules, some people are going to need a little extra help navigating it all.

Here’s how you can help.

If you know someone who is confused, frustrated, or just needs help with their health insurance, have them reach out to MeadorCare. We’d like to help anyone who needs it.

To help us respond as quickly as possible, the best way to reach us is:

1. 1.Text or email us first.

2. 2.If you haven’t heard back within one business day, give us a follow-up call.

We’re working hard to streamline our response time, so questions don’t get left hanging.

Thanks so much for, you are the best.

Ralphie’s Corner

Thes are the acronyms you will see as you are setting up next year's plan.

Medicare

ANOC — Annual Notice of Change
AEP — Annual Enrollment Period
MAPD — Medicare Advantage Prescription Drug Plan
PDP — Prescription Drug Plan
MOOP — Maximum Out-of-Pocket

VA Marketplace

OEP — Open Enrollment Period
APTC — Advance Premium Tax Credit
CSR — Cost-Sharing Reduction
QHP — Qualified Health Plan
SEP — Special Enrollment Period
EHB — Essential Health Benefits

Small Group

FTE — Full-Time Equivalent
MEWA — Multiple Employer Welfare Arrangement
ICHRA — Individual Coverage Health Reimbursement Arrangement
HRA — Health Reimbursement Arrangement
HSA — Health Savings Account
HDHP — High-Deductible Health Plan

MeadorCare Core Values

MeadorCare isn’t just an agency — it’s a movement to fix confusing insurance.