Medicare Open Enrollment Is Happening Now—Here’s What’s At Stake

Key Takeaways

• The Medicare Open Enrollment Period runs from October 15 to December 7 every year, allowing you to make critical changes to your health and drug coverage for the upcoming year.

• If you miss this enrollment window, you may be locked into your current plan until next fall, unless you qualify for a Special Enrollment Period.

What Is Medicare Open Enrollment?

Medicare Open Enrollment, also called the Annual Enrollment Period (AEP), is your once-a-year opportunity to make changes to your Medicare coverage. It happens between October 15 and December 7, and the changes you make take effect on January 1 of the following year.

This window is particularly important if you want to:

• Switch between Original Medicare (Parts A and B) and Medicare Advantage (Part C)

• Change from one Medicare Advantage plan to another

• Enroll in, drop, or change a Medicare Part D prescription drug plan

• Return to Original Medicare from a Medicare Advantage plan

Why This Period Matters More in 2025

In 2025, several changes make this enrollment period even more impactful:

• The $2,000 annual out-of-pocket cap for prescription drugs under Part D has now taken effect.

• The new Medicare Prescription Payment Plan allows you to spread out-of-pocket drug costs over the year, instead of paying them all at once.

• Some supplemental benefits, like over-the-counter allowances and transportation, are being reduced in many Medicare Advantage plans.

These updates may change how well your current plan works for your health needs and budget. That’s why reviewing your options during Open Enrollment isn’t optional—it’s essential.

What You Can Do During This Time

If you’re enrolled in Medicare, here’s what you can do during the Open Enrollment window:

• Review your Annual Notice of Change (ANOC): This document outlines changes to your current plan’s premiums, copayments, deductibles, drug formulary, and benefits for 2025.

• Compare your plan with other options: Even if you’re satisfied with your current coverage, it may no longer offer the best value or benefits for your needs.

• Make changes through Medicare.gov: This is the official platform for comparing plans and enrolling in or switching coverage.

• Seek expert help: You can consult a licensed agent listed on this website if you need help understanding your options or making a decision.

What Stays the Same If You Do Nothing

If you don’t take action during Open Enrollment, your current coverage typically rolls over into 2025. However, that doesn’t mean your plan stays the same. Your:

• Monthly premiums could increase

• Out-of-pocket costs might rise

• Drug coverage might drop certain prescriptions

• Supplemental benefits may be reduced or removed entirely

By not reviewing your plan, you risk higher costs or less coverage without realizing it until it’s too late.

Important 2025 Cost Updates to Consider

While plan-specific prices can’t be discussed, there are some nationwide updates for Medicare in 2025 that affect nearly everyone:

• Part B Premium: Now $185/month for most people

• Part B Deductible: Increased to $257 for the year

• Part A Hospital Deductible: Now $1,676 per benefit period

• Part D Deductible: Capped at $590

• Part D Out-of-Pocket Maximum: Newly capped at $2,000 annually

These updates make comparing plans all the more important, especially if your prescription costs or hospital usage is high.

Who Should Pay the Most Attention This Year

Open Enrollment isn’t just for new beneficiaries or those with major changes. But certain individuals should be especially proactive:

• Anyone with a Medicare Advantage plan whose ANOC shows reduced benefits or increased costs

• Beneficiaries with high prescription drug expenses looking to benefit from the new $2,000 cap

• Those turning 66 or 67 in 2025 who may now need more comprehensive coverage

• Anyone relying on dental, vision, or hearing benefits under Medicare Advantage, which are subject to cuts in some plans

How to Compare Plans Effectively

Comparing Medicare plans isn’t just about premiums. You should evaluate:

• Total out-of-pocket costs: Premiums, deductibles, coinsurance, and copayments

• Drug formularies: Check if your prescriptions are covered and at what tier

• Provider networks: Ensure your preferred doctors and hospitals are included

• Supplemental benefits: Look for dental, vision, fitness, and hearing services if you rely on them

Use Medicare’s Plan Finder tool or speak to a licensed agent listed on this website for help.

Special Enrollment Periods Are Limited

Once the December 7 deadline passes, changes aren’t allowed unless you qualify for a Special Enrollment Period (SEP). These are granted for specific life events, such as:

• Moving to a new area

• Losing other insurance

• Gaining or losing eligibility for Medicaid

• Entering or leaving a long-term care facility

If none of these apply, your next opportunity to change coverage won’t come until October 2025.

What About the Medicare Advantage Open Enrollment Period?

If you enroll in a Medicare Advantage plan during Open Enrollment and later regret it, there is a second chance.

From January 1 to March 31, the Medicare Advantage Open Enrollment Period allows you to:

• Switch from one Medicare Advantage plan to another

• Drop your Medicare Advantage plan and return to Original Medicare (and optionally add a Part D plan)

This opportunity only applies if you already have a Medicare Advantage plan. You can’t switch from Original Medicare to Medicare Advantage during this window.

Key Questions to Ask Yourself Before the Deadline

• Has my health changed in the past year?

• Are my current doctors still in my plan’s network?

• Are my prescriptions still covered, and are they affordable?

• Have premiums or deductibles increased?

• Do I need additional services like dental or vision?

• Would another plan better suit my health or financial needs in 2025?

Answering these questions can help you decide whether to keep your current plan or switch.

Why Waiting Could Cost You

Failing to take action during Medicare Open Enrollment can lead to:

• Higher monthly costs due to increased premiums or copays

• Unexpected prescription drug expenses

• Losing access to preferred providers

• Missing out on better coverage or benefits

Medicare changes every year. A plan that worked well in 2024 might not suit you in 2025. That’s why this window deserves your attention now.

Staying Ahead Starts With One Step

Medicare Open Enrollment is not just another bureaucratic deadline. It’s your one chance this year to take control of your health coverage and financial security. Whether you want to keep your current plan or explore new options, taking the time to review your choices can save you money, prevent surprises, and ensure you get the care you need in 2025.

Get in touch with a licensed agent listed on this website for clear, personal guidance on what steps to take before December 7.