Thinner benefits and coverage changes await many older Americans who will shop for health insurance this fall. Provided that their plan is still available in 2025.

More than a million people will likely have to find new coverage as big insurers cut costs and withdraw from markets for Medicare Advantage plans, the private version of the federal government’s coverage program aimed primarily at people ages 65 and more.

Industry experts also predict price increases for Medicare prescription drug plans as required coverage improvements take effect.

Voters will learn about the insurance changes just weeks before they choose the next president and as Democrat Kamala Harris campaigns on a promise 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 goes up, that’s a very obvious sign that you’re paying more,” said Massey Whorley, an analyst for health care consulting firm Avalere. “This has significant implications for how they view the performance of the current administration.”

Insurance agents say the distraction from the election adds another complication to an already difficult annual enrollment window that begins next month.

Insurers withdraw from Medicare Advantage

Medicare Advantage plans will cover more than 35 million people next year, or about 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 ended a plan or left its market.

Health insurer Humana expects more than half a million customers – about 10% of its total – to be affected by the withdrawal of Medicare Advantage plans from various locations around the country. Many customers will be able to move to other Humana plans, but company executives still expect to lose a few hundred thousand customers.

CVS Health’s Aetna is forecasting a similar loss, and other major insurers have announced they are leaving several states.

Insurers say rising costs and use of care, as well as reductions in reimbursement from the government, are forcing them to step back.

Some people may expect a difficult search

When insurers exit the Medicare Advantage markets, they tend to stop selling plans with lower quality and those with a higher proportion of black buyers, said Dr. Amal Trivedi, a public health researcher at the Brown University.

He noted that exiting the market can be particularly difficult for people with multiple doctors and for patients with cognitive conditions like dementia.

Most markets will still have dozens of plan choices. But finding a new option involves understanding the direct costs of each choice, as well as determining how doctors and regular prescriptions are covered.

“People don’t like change in health insurance because they don’t know what’s on the other side of the fence,” said Tricia Neuman, a Medicare expert at KFF, an organization nonprofit that studies health care.

Plans that don’t leave the marketplaces may increase deductibles and reduce benefits such as cards used to pay for utilities or food.

These have proven popular in recent years as inflation has risen, said Danielle Roberts, co-founder of Fort Worth, Texas-based insurance agency Boomer Benefits.

“It’s really hard for someone on a fixed income to choose a health plan for the right reasons…whereas $900 on a flex card on free groceries seems pretty good,” she said.

Don’t “sleep” while choosing a Medicare plan

Prices could also rise for some so-called stand-alone Part D prescription drug plans, which people associate with traditional Medicare coverage. KFF says the population includes more than 13 million people.

The Centers for Medicare and Medicaid Services said Friday that premiums for those plans will drop about 4% on average to $40 next year.

But brokers and agents say premiums can vary widely and they always expect some increases. They also expect fewer plan choices and fewer changes to formularies or lists of covered medications. Roberts said she has already seen premium hikes of $30 or more in some plans for next year.

Any price changes will hit a customer base known for switching plans for premium changes as small as $1, said Fran Soistman, CEO of online insurance marketplace eHealth.

The changes come as a policy overhaul approved by Congress takes effect. Most notably, out-of-pocket drug costs will be capped at $2,000 for people on Medicare, an effort championed by Democrats and President Joe Biden in 2022.

In the long term, these changes will result in “much greater benefits,” Whorley said.

KFF’s Neuman noted that capping drug costs will be especially helpful to cancer patients and others with expensive prescriptions. She estimates that around 1.5 million people will benefit.

To avoid large premium increases due to these changes, the Biden administration will withdraw billions of dollars from the Medicare trust fund to pay insurers to keep premium prices low, a move criticized by some Republicans. Insurers will not be allowed to increase premium prices beyond $35 next year.

People will be able to sign up for 2025 coverage between October 15 and December 7. Experts say all the potential changes make it important for buyers to closely study any new choices or coverage they’re considering renewing.

“This is not a year to sleep on this, just get back to business as usual,” said Whorley, the health care analyst.

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Education Media Group. The AP is solely responsible for all content.