Changes to Consider for Medicare Open Enrollment 2025

Are you hearing about Medicare open enrollment 2025 and wondering what it might mean for you? It’s important to understand what it is and why you may want to take this time to review your coverage options.

Medicare is the primary health insurance for most Americans 65 and over. Considering how important health care is and the associated costs, it’s crucial to have the right coverage. Medicare open enrollment is a period when you can purchase or change your Medicare coverage.

Here’s what you need to know to make the most of it.

What Is Medicare Open Enrollment?

Medicare open enrollment, also called the annual enrollment period, is the window of time when anyone who qualifies for Medicare can purchase or change their coverage. Each year, this period begins on October 15 and goes until December 7.

Medicare has several parts and restrictions on when you can sign up.

• Parts A and B are hospital and medical insurance. These are government-provided and together referred to as “Original Medicare.”
• Part C (also known as Medicare Advantage) is private coverage purchased through an insurer that encompasses Parts A and B.
• Medicare Part D provides drug coverage.

If you qualify for premium-free Part A—as most people do—you can enroll at any time once you become eligible. For other parts, you can only enroll or change coverage at certain times.

The first time you can sign up is called your initial enrollment period. This begins three months before and lasts for three months after the month you turn 65. Including your birth month, it’s a seven-month period. Another time is during open enrollment.

What Happens During Medicare Open Enrollment?

During the annual open enrollment period, you can change your Part C Medicare Advantage plan or Part D drug coverage. Specifically, you can:

• Sign up for a Medicare Advantage (Part C) plan, change to a different plan if you already have one, or drop it entirely.
• Add a Part D drug plan if you’re not already enrolled, change to a different one, or drop an existing plan.
• You can also switch between Parts C, D, and Original Medicare Parts A and B.

After your initial enrollment period, this is generally the only time you can add or change these parts of your Medicare coverage.

When Does Coverage Begin?

Any changes you make to your Medicare coverage during the open enrollment period take effect on January 1 of the following year. So, if you change your coverage during Medicare open enrollment 2025, the coverage becomes effective on January 1, 2026.

If You Already Have Medicare, Why Does Open Enrollment Matter?

Even though you have Medicare coverage, your needs may have shifted and you might be better off with a different plan. For instance, you may have Original Medicare but a Medicare Advantage plan now suits you better. Or you may not have a Part D drug plan and want to add one. Open enrollment is your opportunity to make the appropriate switch.

Your existing coverage can also change. Just like your car or home insurance, Medicare Advantage plans are private insurance products that insurance companies offer. That means you should periodically evaluate them and compare your options. Medicare coverage components can also change due to legislation. For example, beginning in 2025, all Medicare plans will cap out-of-pocket prescription drug costs at $2,000. This is the most you’ll pay for covered drugs during a calendar year. If you take prescription drugs, particularly expensive ones, open enrollment is a good time to compare plans to find one that covers them.

If you’re enrolled in a Part C or D plan, your insurer is required to give you an annual notice of change letter in September notifying you of any coverage changes.

You may want to consider how changes may affect certain aspects of your plan, particularly concerning coverages and cost:

What Does Your Plan Cover (and How Might It Change)?

• Review any medications you take, including current or new ones you’ve recently started.
• What are the eligibility requirements for having these medications covered? Do you meet them? Would you qualify under another plan’s rules?
• What are the copays on those specific medications? Can you choose between generic and brand names?

What Are the Total Costs for Services Under Your Current Plan, and How Might Those Change?

• Consider your monthly premium. Are you paying for coverage you don’t need or use? Compare plans to see which one gives you the most cost-effective coverage.
• The premium alone doesn’t account for the total cost. Look at any copays or deductibles you pay for services or medications covered under Part C or D. One plan may have a higher premium but the total costs of obtaining care may be lower due to lower copays or deductibles.

If you find that a different plan better meets your needs or you can get the coverage you need with a less expensive alternative, the open enrollment period is your chance to make these changes.

Take Steps Now to Review Your Coverage and Make Plans for Open Enrollment

Open enrollment doesn’t have to be stressful if you plan ahead. Start by reviewing your regular health care expenses, such as treatments or prescriptions, and any needs you anticipate in the near future. Evaluating your plan and comparing it to others can help you understand which plan offers the right coverage for you.

And remember, even if you miss the annual enrollment period, it’s possible to get the coverage you need.

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Colonial Penn is an insurance company and is not affiliated with or endorsed by the U.S. government or Medicare. Colonial Penn does not offer Medicare plans. The information provided relates to general insurance matters. Insurers and their representatives cannot give tax or legal advice. This article is for general educational purposes related to insurance. Seek personalized advice from qualified tax or legal advisors.

This information is for educational purposes only and is not a substitute for professional medical, legal, or financial advice. For specific Medicare questions, visit www.medicare.gov or call 1-800-MEDICARE (1-800-633-4227, TTY 1-877-486-2048).We strive for accuracy but make no guarantees. Policies and regulations can change. Verify information with authoritative sources and consult professionals where necessary.