Everything you need to know about upcoming Medicare changes

Patrice King Brown: Whether you’re new to Medicare, exploring your options, or just want keep up with the latest in Medicare news, we've got you covered.

Stacy Smith: No fluff. No jargon. Just real conversations to help you navigate Medicare with confidence. I’m Stacy Smith.

Patrice King Brown: And I’m Patrice King Brown. Welcome to Medicare for the Record brought to you by UPMC for Life.

Patrice King Brown: Welcome. This is the first episode of a new podcast, “Medicare for the Record,” where you will learn about all the changes coming to Medicare Advantage this next year.

Stacy Smith: And there are a lot of changes coming, especially in Part D and other parts of the Medicare Advantage plan for people who are on Medicare. We’re going to get into some of those, and one of the people that are going to help explain what’s happening with these changes and coming in 2026 is our first guest, and that would be Angie Moczan, the Chief Operations Officer for UPMC Medicare products at UPMC Health Plan.

And Angie, there is a lot to discuss here. So before we get into that, can you tell us a little bit about your background?

Angie Moczan: Sure. Thank you for having me this morning. I have been with UPMC for 23 years and in Medicare for about 10 of those years. My background is actually in finance. I’m a certified public account, or CPA, and I began my career at a big public accounting firm and I got an opportunity to get exposed to a lot of different industries like manufacturing, construction, higher education, and financial services. But I had an opportunity to join UPMC, and when I did, I joined on the corporate side of the business. That’s where I had a fantastic opportunity to learn about health care in general, and I really found my passion for the health care industry. I had an opportunity to learn about the larger picture of the organization, and we really focused, while I was there, my tenure, on the provider side of the organization for care delivery. Then I transitioned over to the Health Plan side and that’s when I was able to pull a lot of the pieces together, really able to take seeing our members as the patients who had to flow through the continuum of care and the costs that they incurred while doing that. So I really am dedicated to bringing that overall picture of the organization and the business needs and combine it with what the members need for their health.

Patrice King Brown: Well you know, Angie, this whole Medicare situation is very confusing for so many people. And will you remind us, what is Medicare Advantage? What’s a Medicare Advantage plan and why is this time of year so important to the members?

Angie Moczan: Yeah, thank you. That’s a really great question. A Medicare Advantage plan is really designed to help cover some health care costs that Original Medicare does not. If you’re on a Medicare Advantage plan like UPMC for Life, you will be eligible for extra benefits like dental, vision, hearing, and fitness memberships as well as your prescription drug coverage, and it’s all in one plan.

Patrice King Brown: OK. So again, there’s so much, you know, that could be involved. So this time of year we are expecting changes or we will be notified about changes. What is it?

Angie Moczan: Yeah, so it is an important time of the year. It is when your annual notice of change comes out to all of the members. This will be mailing very soon, and this document really tells you about what all the changes that you should be expecting and your cost and your coverage for the upcoming year. So it’s really important to make sure that you review that document and if you don’t understand something, just call your insurance carrier to learn more about it.

Stacy Smith: So there are a lot of changes coming up, Angie, in 2026. So what are some of the more important changes that people may be facing?

Angie Moczan: Yeah, there are a lot of changes that have been happening in the health care industry and in the insurance industry as well. And as there are more changes that actually usually leads to Medicare changes. So that’s what you’re seeing. One of the trends that has been happening is individuals across the nation have been seeking care at a much higher rate than we’ve seen in recent history, and that creates financial pressures for all parties involved. So plans like the Medicare Advantage plans will work together with their providers to come up with some new solutions on try to address those pressures.

Patrice King Brown: Do you think some of that has to do with the fact that we are indeed an aging population?

Angie Moczan: I do. And I think also after the opening of the pandemic, people were really looking to make sure they were taking care of themselves. We know that taking the best care is how we can really drive the financial pressure issue.

Patrice King Brown: Right. Now, you mentioned there were some changes. Will these changes affect the extra benefits that have been part of Medicare Advantage plans?

Angie Moczan: Yeah, so the Medicare Advantage plans really strive to offer our members the financial protection and stability that they’re really looking for. We are working with the providers and the drug makers on new innovative solutions to try to address the rising medical and pharmacy costs. By doing that, that helps to lessen the impact on the member, and it also allows the plans to put funds toward the extra benefits like the dental, vision and hearing, and fitness. Some plans like UPMC for Life also offer extra benefits on top of that. There are allowances that help you pay for things like health care products or doctor office copays, home safety devices. So there are things that we know are very important to keeping the member at their best health.

Stacy Smith: So there’s more than one plan for UPMC for Life on the Medicare Advantage. Can you, are they different costs? I mean, do some have more benefits than others?

Angie Moczan: We refer to it as our product portfolio, and really that portfolio is designed to try to have something for everyone. You come into Medicare, you’re at a different stage; when you’ve been in Medicare for maybe 15 years, you’re at a different stage and then on with the journey. So we try to have a plan that fits everybody’s needs from a health perspective as well as their budgets.

Stacy Smith: Well, how do you; as a person who’s taking a look at these, how should I go about analyzing what I might need?

Angie Moczan: Yeah, you have to take in a lot of factors, most of which is what are your care needs? Do you use certain prescription drugs? Do you go to see a specialist? Do you have certain doctors that you like to continue your care with? Are there certain facilities? So network is really important as well, and then you marry that—what your health needs are—you marry that with what are the costs that you would have to pay to access that care through copays.

Patrice King Brown: So many people are having financial difficulties or have special needs or have less than others, but still need health care for whatever reason. Are there plans that are part of the Medicare Advantage plan at UPMC that can make a difference for them, too?

Angie Moczan: Yes. Thank you for bringing that up, because we have the plans that we offer in the market, but part of some of the innovative solutions that we’re working on would be different types of models of care that we offer to our members that are actually, they’re included in your benefit, but they’re not actually a Medicare benefit. There are things that the plans do with providers to help address needs for our most vulnerable members or even our members who maybe they have diabetes or chronic kidney disease and they might have need to see a dietitian or need to see different types of specialists for their care.

So we have a really great example of what’s called an integrated care model where it’s really a comprehensive approach to the care. UPMC for Life partners with a group of UPMC providers to offer what’s called the Your Care program, UPMC Your Care. That program is really a comprehensive in-home team-based approach to adding resources for members that are our most vulnerable and in Allegheny County. So under that particular type of model, we give a personalized care plan to each person who’s eligible for it, and then they also receive a dedicated care manager. That care manager can be contacted at any time by the individual for whatever they might need.

Stacy Smith: A person who’s looking to go onto a Medicare Advantage plan with UPMC, should you be taking a look down the road? Let’s just say your doctor says you may be facing X, Y, Z. Is there a way to try to analyze which plan you should be on for the coming year?

Angie Moczan: Yes, so, and we have really great tools that are out there. Medicare Plan Finder is one of those tools to help you do a comparison of the plan. So if you’re looking for something specific, that’s a great place to go. It’ll list the plans out and what the copays are for the care that you’re looking for. So if you’re planning for a procedure, you want to see a particular doctor or go to a particular facility, that’s a great way to identify it and it kind of lists it out so that you can understand, hey, when I’m going to my primary care physician, it’s a $0 copay with this particular plan, if I have to go see a specialist, it’s 20 bucks. So it helps you just understand what kind of cost you may be facing in the future. There’s really great options for plans. Everything from $0 costs to getting into the hundreds of dollars depending on the type of coverage that you need for yourself.

Stacy Smith: Does it make any difference what prior medications or surgeries or anything else that you’ve had, if you want to switch to a different plan?

Angie Moczan: That’s what’s really great about Medicare Advantage. There is none of that that is a concern. You can join Medicare Advantage with any type of condition and on any drugs.

Stacy Smith: Angie, you’d like to go back to part D for a second, because it’s very critical as far as medications go. So what kind of changes are going to be happening where members can get their medications and how they get their medications?

Angie Moczan: Yeah, we’re going to go into this in a lot more detail in our next episode so that we can make sure our listeners understand the important changes that are happening. But overall, members in a Medicare Advantage plan are seeing an overall decrease in their cost for prescription drugs.

Insurers and drug makers are now responsible for a higher portion of the drug costs and that is really working to reduce the cost burden for our members, especially those who are in need of the higher-cost drugs. So overall, what you’ll be seeing if you’re in a Medicare Advantage plan is them stabilizing their benefits around prescription drugs and really making sure that the members can receive their prescription drugs at an affordable cost.

Patrice King Brown: You know, you mentioned earlier a Your Care program, UPMC Your Care. This program sounds great, really sounds like it’s having a positive impact on the community. What are some of the other ways that UPMC works with providers?

Angie Moczan: Plans are working across their networks with their providers to make sure that they can offer access to the members at an affordable quality, at an affordable price and for quality care. Additionally, the health plans want to work with the providers to make sure that they’re collaborating on the member’s care so that they’re getting the right care at the right place at the right time for the member’s health need.

Patrice King Brown: Good program.

Stacy Smith: All right. We are in the fall. We’re talking about changes coming in 2026. So when can you start to make the changes to your Medicare Advantage plan?

Angie Moczan: You can start learning about your Medicare Advantage plan options for 2026 beginning on Oct. 1. That is when the plans are required to have their information out to the Medicare consumers on their websites. They may also mail the information to the individuals as well as talk to them about it over the phone. And some plans may have local meetings where you can attend to learn more about the plan.

So there are certain times of the year that you can make changes and apply there. The most common is the Annual Enrollment Period, which runs from Oct. 15 to Dec. 7. That is when everybody is eligible to make a change to their plan. You can add or drop part D prescription drug coverage, or you can change to a different Medicare Advantage plan, or you can change to just Original Medicare.

Stacy Smith: So what happens if you, let’s say, when you can start to enroll in the fall and you have second thoughts about it, and maybe this isn’t the right plan. Can you make changes at that point?

Angie Moczan: Absolutely. Yeah. You don’t have to worry because there’s also what’s called an Open Enrollment Period, which runs from Jan. 1 to March 31. You can add Part D, add or drop Part D, you can switch to another Medicare Advantage plan, or you can switch to Original Medicare.

Stacy Smith: Let’s say that something else happens. I have no idea what major change in life might be, maybe what, your spouse might pass away or something to that effect. Can you make any changes past that period?

Angie Moczan: Yeah, so after March 31, the only option to change is when you’re granted what’s called a Special Election Period. That is when certain events happen in your life that may cause you to need to have a change in your coverage. So for example, you may move out of your current plan service area. Another example would be if you were moving into or leaving a nursing home or long-term care facility. Another example might be that you might become eligible for additional government assistance or extra help where you may become eligible for Medicaid or for a special needs plan.

Patrice King Brown: I’m not sure people are all aware of that, that you can make those changes.

Stacy Smith: No, and I think that also—is there help—I think you kind of mentioned this—help available to understand the changes that are made in the upcoming year? I mean, sometimes you can get into—you see a document, it can be legalese of some sort.

Angie Moczan: Yeah. There are really great tools that are available for individuals to compare plans. You can work with an individual who will come out to your home. You can call your insurance carrier to get more information about the plans that are eligible. Or you could also go onto different websites. There’s Medicare Plan Finder, for example, that will help you give you a view where you can compare the different options of the plans. And based on what your individual needs are and what your budget allows, you can make a choice from there.

Patrice King Brown: So Medicare Plan Finder is also something that’s available. These are all very good options. Lots of good information out there. Although sometimes it can be overwhelming, it’s nice to know that there’s also help available.

Angie Moczan: Our mission is to make sure that we’re able to try to offer a high-quality plan at the most affordable price.

Stacy Smith: Angie Moczan, thank you so much for joining us, Angie, once again is the Chief Operations Officer for UPMC Medicare products at UPMC Health Plan. Very informative, a lot of changes, a lot we discussed today and luckily people can come back into this podcast whenever they need to and go over it again. But thank you for joining us.

Angie Moczan: Thank you. Appreciate you having me.

Patrice King Brown: Thanks, Angie. So, there are some things for you to remember. We have some takeaways from today’s conversation. Remember that your annual notice of change will be coming by Oct. 1, 2025.

Stacy Smith: We should also note that Medicare Advantage Plans can help stabilize benefits and work hard to offer extra benefits that help members stay healthy and also independent, which I think is important.

Patrice King Brown: It is absolutely important. Now, if you want to make changes too, remember that you can. If you want to change your plan during that time, there is the annual enrollment period, and that begins Oct. 15 and runs through Dec. 7.

Stacy Smith: And for more information, you can find it at Medicare.gov, CMS.gov, or the UPMC for Life website, which is upmchealthplan.com/medicare.

Patrice King Brown: Thank you so much for joining us today. We hope you’ll join us for our next episode of “Medicare for the Record.” We’re going to share as much information with you as we possibly can so that you are prepared for the enrollment and know what is available to you through UPMC Medicare Advantage Plans.

Thanks for tuning in to Medicare for the Record brought to you by UPMC for Life. To learn more about your Medicare options, visit: Upmchealthplan.com/fortherecord

This podcast is provided for general informational and educational purposes only. It is not medical care or advice. For questions regarding medical care, please consult with your health care provider.

Views and opinions expressed by the participants are solely on their own and do not necessarily reflect those of UPMC Health Plan, its subsidiaries, parents, or affiliates.

UPMC for Life has a contract with Medicare to provide HMO, HMO D-SNP, and PPO plans. The HMO D-SNP plans have a contract with the PA State Medical Assistance program. Enrollment in UPMC for Life depends on contract renewal. UPMC for Life is a product of and operated by UPMC Health Plan Inc., UPMC Health Network Inc., UPMC Health Benefits Inc., UPMC for You Inc., and UPMC Health Coverage Inc.

Y0069_251668_M