March 2025 MediGap Advisors Health & Wealth Newsletter  Vol. 28, Issue 3

What Medicare Patients Can Expect From the Trump Healthcare Plan?

 It’s official! Robert F. Kennedy Jr. is the new Secretary of Health and Human Services (HHS) after a nearly party-line confirmation vote.

The Trump administration has already moved swiftly in other departments, and Kennedy is expected to spearhead major reforms in Medicare and senior healthcare. His leadership signals a new direction for Medicare Advantage, prescription drug pricing, holistic healthcare, and alternative models like health sharing.

I’ve followed Kennedy’s work for years and, of course, have spent my career studying healthcare finance and policy. Based on Trump’s past Medicare initiatives and Kennedy’s priorities, here’s what I believe are the seven biggest changes coming for seniors.

Here’s a breakdown of what Medicare beneficiaries and seniors can expect under Kennedy’s leadership and Trump’s healthcare agenda.

1. Cost Reductions, Not Benefit Reductions

During the election, the Trump campaign advocated for significant reductions in Medicare costs – particularly in the Medicare Advantage program, which has been beset by inefficiency and outright fraudulent overbilling.

Both Trump and Kennedy believe they can find significant cost reductions without reducing benefits to seniors. They have committed to maintaining the same level of Medicare benefits or better.

Thus far, Elon Musk and the Department of Government Efficiency (DOGE) have been successful in flushing out massive overpayments in other departments. I believe they’ll find billions of dollars in cost-reduction opportunities in Medicare as well.  

If the non-partisan Committee for a Responsible Federal Budget is correct, fixing the Medicare Advantage overpayment problems could save as much as $300 billion over the next ten years.

This can and should be done without cutting benefits at all.

2. Prescription Drug Coverage Reform

Kennedy has been one of the loudest critics of Big Pharma and drug pricing. Expect major changes to Medicare Part D and prescription drug price negotiations.

Possible reforms under RFK include: 

  • Stronger drug price negotiations for Medicare beyond the limited Biden-era program.
  • Expanded access to lower-cost generics and alternative medications.
  • Tougher regulations on Pharmacy Benefit Managers (PBMs) to prevent price manipulation.
  • Possible price caps on specific drugs. 

Medicare has massive buying power. So we should benefit from aggressive but good-faith negotiations with drug manufacturers to reduce costs. That’s good for Medicare beneficiaries and good for the taxpayer.

I’m skeptical of price caps in general, as they have a long record of resulting in shortages and less investment in R&D. That leads to worse health outcomes in the long run.

3. More Access to Alternative Health Sharing Plans 

Health sharing plans have become a popular alternative to traditional insurance.

With good reason: They offer powerful protection against unexpected catastrophic medical costs, generally at a fraction of the price of traditional insurance products. 

The Medi-Share 65+ health sharing plan, in particular, is a compelling and cost-effective alternative to traditional Medicare supplement (Medigap) plans. 

Under the new Administration, we could see fairer tax treatment of health sharing plans. This would make them even more competitive, especially for healthier enrollees. 

  • Expanded access to  health sharing plans for seniors seeking non-insurance alternatives;
  • Expansion of health insurance tax deductions to include health sharing plans;
  • More price transparency, which makes it easier for careful shoppers to find discounts for cash payers (including health sharing plan members) on common medical services. 

At MediGap Advisors, we’re all about more choices, more transparency, and more healthcare freedom. We would welcome reforms that expand access to health sharing alternatives.

If you’re a Medicare beneficiary and you want a plan that limits your total Medicare Part A and B out-of-pocket expenses to just $500 per year for your household – at a much lower cost than a comparable Medigap Plan G or similar Medicare supplement plan, you should definitely contact your PBM to discuss.

Oh, and you don’t have to wait until open enrollment to do it. If switching to health sharing makes sense for you, you can do it at any time.

4. Expansion of Alternative & Holistic Healthcare Benefits

Kennedy has long supported natural and integrative medicine. Under his leadership, Medicare may expand coverage for non-standard treatments.

Here are some of the changes we could see:

  • Less emphasis on drug therapies and more on preventive care, nutrition, and lifestyle-related benefits. 
  • More coverage for acupuncture, chiropractic, and functional medicine for chronic conditions.
  • Expansion of telemedicine benefits to include for holistic health practitioners and naturopathic doctors.

We may see a wave of innovative supplemental benefits in Medicare Advantage plans in the next few years. Keep an eye out for expanded Medicare pilot programs in these areas.

We’ll let you know about new benefits rollouts in this newsletter, or on the MediGap Advisors blog, which you should also be checking regularly!

And it’s a good idea to do a personal benefits review each year or two with your PBM (the person who sent you this newsletter)! That way, as new benefits and plans roll out, you can be sure you’re still enrolled in the best plan for your needs and budget.

5. Medicare Fraud Prevention & Waste Reduction

Medicare fraud and waste cost taxpayers billions every year. 

The Trump administration has previously targeted fraud aggressively, and Kennedy may further tighten controls – especially on Medicare Advantage companies implicated in overbilling.

Some possible measures include:

  • Stricter eligibility checks for new enrollees
  • More audits of Medicare Advantage plans and providers
  • Tighter fraud detection systems to prevent improper payments

Seniors should stay updated on any new verification requirements to avoid disruptions in coverage.

6. More Transparency in Medicare Pricing & Billing

Kennedy has long called for more transparency in healthcare pricing. 

Expect new rules requiring hospitals, insurers, and drug companies to disclose costs upfront.

Here are some changes I expect in the coming months:

  • Hospitals and doctors required to list procedure costs upfront
  • More price comparison tools for Medicare patients
  • Easier-to-understand billing statements for seniors
  • More protection against “surprise billing”

We’ll see some resistance from large, established insurance companies and hospitals. But more transparency is better. This means more opportunities for you as a healthcare consumer to find the best value and make smarter healthcare decisions.

As providers are forced to compete, they’ll have to show value to attract patients. That helps keep costs down, and quality high.

7. Stricter Eligibility Criteria for Non-U.S. Citizens

The previous Trump administration previously tightened “public charge” eligibility rules for legal immigrants in public health programs.

The Biden Administration loosened those rules. But Secretary Kennedy may reinstate the rule, making it harder for legal immigrants to access taxpayer-subsidized public health benefits like Medicaid and Medicare.

Possible changes include: 

  • Stricter proof of self-sufficiency for new legal immigrants
  • Limitations on Medicaid access for certain immigrant groups
  • Tougher documentation requirements for enrolling in Medicare

This will free up more resources for native-born or naturalized U.S. citizens and permanent residents. But non-citizens in some categories will have a harder time accessing taxpayer-funded benefits.

What About Weight Loss Drugs (Wegovy and Ozempic)? 

Mr. Kennedy has expressed some skepticism over new blockbuster weight loss drugs like the popular Ozempic and Wegovy. 

He much prefers diet and exercise to pharmacological weight loss. However,But the Health Secretary does not have the power to unilaterally revoke FDA approval. So if you do choose to use these drugs, the FDA won’t be banning their approval for U.S. markets anytime soon.

For Medicare beneficiaries, Medicare allows Part D plans to cover Ozempic and Mounjaro for diabetes, and Wegovy for obesity and heart disease.

However, each plan’s formulary varies. Medicare rules prohibit the Secretary from interfering in what drugs each plan chooses to cover, as long as they cover drugs in each of the required pharmacological categories.

However, if you want access to these drugs via your Part D plan, you should check the plan’s formulary before signing up to make sure the drugs are included. Also, check what pricing tier they are under, so you know what your copay will be when you fill your prescription.

Steps to Take

With major Medicare reforms coming, you should definitely stay up-to-date with the latest Medicare and retirement news.

So keep reading this newsletter, and read the MediGap Advisors blog, which is updated every week, as new information comes out.

Stay in touch with your PBM, who’s an expert on both health insurance and health sharing. That sets our team apart from 90% of other health benefits brokers.

Need Help?

Your expert Personal Benefits Manager can help you compare options and ensure you’re in the best available plan.

Consultations are free of charge. So make an appointment for an annual review today!

Thanks for reading the MediGap Advisos Health and Wealth Newsletter, and have a fantastic spring!

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Here’s to your health and wealth,

Wiley P. Long, III
President – MediGap Advisors

 

 

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MediGap Advisors does not provide tax advice. The information in this newsletter is for general informational purposes only. For information specific to your personal situation, you should additionally consult a qualified tax professional.