ES: Medicare Open Enrollment Kicks Off

Medicare's Open Enrollment period began on October 15 and runs through 7 December.

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.

closeup of a Medicare health insurance card with a paperclip

During this period, you can:

• Switch from Original Medicare (Part A and Part B) to a Medicare Advantage (Part C) Plan, or return to Original Medicare
• Change from one Medicare Advantage Plan to another
• Switch between a Medicare Advantage Plan with prescription drug coverage and one without prescription drug coverage
• Join a Medicare Part D prescription drug plan, change from one Part D plan to another, or drop Part D coverage
  

Changes made during Open Enrollment take effect on January 1, 2025.

Original Medicare includes Part A (hospital insurance) and Part B (medical insurance). The federal government administers Original Medicare directly. It offers standardized premiums, deductibles, copayments, and coinsurance amounts.

A Medicare Advantage (Part C) Plan provides an alternative to Original Medicare. These plans cover all Original Medicare services and often include prescription drug coverage and additional benefits. Medicare-approved private companies offer these plans. Costs such as premiums, deductibles, copayments, and coinsurance vary by plan.

Medicare Part D drug plans also come from Medicare-approved private companies. These plans help cover the cost of prescription medications.

Key changes for 2025

Medicare Part D:

As of January 1, all Medicare Part D plans will include an annual $2,000 cap on out-of-pocket on 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.

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.

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 at cms.gov to find out if a program is available in your area.

Compare your options

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.

Get Help

Understanding your current Medicare coverage and comparing it with other plans can feel confusing. Fortunately, help is available. You can call 1-800-MEDICARE or visit the Medicare website to use the Plan Finder and other comparison tools. These resources can make it easier to evaluate your options.

You can also contact your State Health Insurance Assistance Program (SHIP) for free, personalized counseling. Visit shiphelp.org to find your state’s phone number and website.

Important Disclosures

This material may address tax matters. It does not provide tax advice and cannot be used to avoid legal penalties. Each taxpayer should seek independent guidance from a qualified tax professional based on individual circumstances.

These materials are provided for general information and educational purposes only. They rely on publicly available sources believed to be reliable, but accuracy and completeness cannot be guaranteed. The information may change at any time without notice believed to be reliable — we cannot assure the accuracy or completeness of these materials. The information in these materials may change at any time and without notice.

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