Medicare open enrollment runs through December 7. Discover new benefits, plan changes, and tips for choosing the best coverage for your needs.
Medicare’s open enrollment period for 2025 runs from October 15 through December 7, and it’s the perfect time to review your current plan and explore whether switching to a new plan might better suit your healthcare needs.
Every year, plans change, and so do your health needs, making it essential to compare available options. During this period, you can make several changes, such as switching from Original Medicare to a Medicare Advantage Plan, changing between different Medicare Advantage Plans, or adjusting your prescription drug coverage.
FAQs
Q1: What changes can I make during Medicare Open Enrollment?
A1: During this period, you can switch between Original Medicare and Medicare Advantage, change Medicare Advantage Plans, modify your prescription drug coverage, or join or drop a Medicare Part D drug plan.
Q2: What are the major changes to Medicare for 2025?
A2: Key changes include a $2,000 annual cap on out-of-pocket prescription drug costs for Medicare Part D plans, mid-year benefit statements for Medicare Advantage enrollees, and expanded access to a dementia caregiver support program called GUIDE.
Q3: How can I compare Medicare plans during Open Enrollment?
A3: You can use the Medicare Plan Finder on medicare.gov to compare plans in your area, check quality ratings, and review prescription drug costs.
Q4: Where can I get help understanding my Medicare options?
A4: You can call 1-800-MEDICARE, visit medicare.gov, or contact your State Health Insurance Assistance Program (SHIP) for free, personalized counseling.
Medicare Open Enrollment Period for 2025
Medicare‘s open enrollment period began on October 15 and runs through December 7.
If you are covered by Medicare, it‘s time to compare your current coverage with other available options. Medicare plans can change every year, and you may want to switch to a health or prescription drug plan that better suits your needs or your budget.
Whether you want to switch from Original Medicare or change between different Medicare Advantage Plans, this is your opportunity to ensure you’re getting the best coverage at the right price.
Options During Open Enrollment
During this period, you can:
- Switch from Original Medicare to a Medicare Advantage Plan, and vice versa
- Change from one Medicare Advantage Plan to a different Medicare Advantage Plan
- Change from a Medicare Advantage Plan that offers prescription drug coverage to a Medicare Advantage Plan that doesn‘t offer prescription drug coverage, and vice versa
- Join a Medicare Part D drug plan, switch from one Part D plan to another, or drop your Part D coverage
Any changes made during open enrollment are effective as of January 1, 2025.
Coverage Options in Open Enrollment
Original Medicare
Original Medicare (Part A hospital insurance and Part B medical insurance) is administered directly by the federal government and includes standardized premiums, deductibles, copays, and coinsurance costs.
Medicare Advantage
A Medicare Advantage (Part C) Plan is an alternative to Original Medicare. Medicare Advantage Plans cover all Original Medicare services and often include prescription drug coverage and extra benefits.
They are offered by private companies approved by Medicare.
Premiums, deductibles, copays, and coinsurance costs vary by plan
Medicare Part D
Medicare Part D Drug Plans, like Medicare Advantage Plans, are offered by private companies and help cover prescription drug costs.
Key Medicare Changes For 2025
Original Medicare
Starting in July, more caregivers of people with dementia who are not residing in a nursing home and are covered by Original Medicare may have access to a model program called Guiding an Improved Dementia Experience (GUIDE).
This program, which initially rolled out in July 2024, provides a 24/7 support line, care coordination, referrals to community-based social services, caregiver training, and respite services.
Although this program will be expanded in 2025, it won‘t be available in all communities. Visit the CMS Innovation website to find out if a program is available in your area.
Medicare Advantage
During the summer, Medicare Advantage Plans will send out a mid-year statement to enrollees that shows supplemental benefits available but unused and remind enrollees how to take advantage of them.
Medicare Part D
As of January 1, all Medicare Part D plans will include an annual $2,000 cap on out-of-pocket costs for prescription drugs covered by the plan.
No copayment or coinsurance costs for Part D drugs will apply for the rest of the year
In addition, enrollees can opt in to a Medicare Prescription Payment Plan to pay their out-of-pocket prescription drug costs monthly rather than all at once at the pharmacy.
Compare Your Options During Open Enrollment
Start by reviewing any materials your plan has sent you:
- Look at the coverage offered, the costs, and the network of providers, which may be different than last year
- Maybe your health has changed, or you anticipate needing medical care or new or pricier prescription drugs
If your current plan doesn’t meet your health-care needs or fit your budget, you can make changes.
If you’re satisfied with what you currently have, you don’t have to do anything — your current coverage will continue
If you’re interested in a Medicare Advantage Plan or a Medicare Part D drug plan, you can use the Medicare Plan Finder on medicare.gov to see which plans are available in your area and check their overall quality rating.
For personalized information, you can log in or create an account to compare your plan to others and see prescription drug costs
Getting Help during Open Enrollment
Determining what coverage you have now and comparing it to other Medicare plans can be confusing and complicated, but help is available.
Call 1-800-MEDICARE or visit the Medicare website to use the Plan Finder and other tools that can make comparing plans easier.
You can also call your State Health Insurance Assistance Program (SHIP) for free, personalized counseling.
Visit shiphelp.org to find the phone number and website address for your state
Protect Yourself From Fraudulent Activities
During open enrollment, there is a higher risk than usual for fraudulent activity.
Medicare has rules about how plans can and cannot communicate with you to market their insurance products.
- Plans are allowed to send you mail and emails but are not allowed to call or visit you in person without your permission.
- Watch out for people who pressure you to join their plan, tell you they represent Medicare and want to offer free services, or inform you that you will lose your Medicare benefits unless you sign up for a certain plan.
- Before you enroll in a plan, make sure you understand what the plan covers and whether it covers the drugs you need.
- Contact a plan directly to learn about the services it covers and get everything in writing.
As Medicare open enrollment approaches, it’s crucial to take advantage of this annual opportunity to reassess your healthcare needs and explore the evolving landscape of Medicare coverage.
The significant changes coming in 2025, particularly the cap on prescription drug costs and enhanced support for caregivers, underscore the importance of staying informed and proactive about your healthcare decisions.
By carefully reviewing your current plan, comparing available options, and seeking expert guidance when needed, you can ensure that your Medicare coverage aligns with both your health requirements and financial considerations.
Remember, the choices you make during this period will impact your healthcare throughout the coming year, making it essential to approach Medicare open enrollment with diligence and care.
Take the time to explore your options, ask questions, and make informed decisions to secure the best possible healthcare coverage for your unique situation.
Contact your tax and financial advisors to determine the best moves for your situation.