Key Takeaways

• Skipping plan reviews and changes during Medicare Open Enrollment can lead to higher costs and limited coverage options.

• Understanding deadlines, costs, and coverage details is crucial to making informed decisions that protect your health and finances.

Missing the Medicare Open Enrollment Deadline Could Cost You

Medicare Open Enrollment runs from October 15 to December 7 each year, giving you the opportunity to review and make changes to your coverage. If you miss this window, you’re stuck with your current plan for another year unless you qualify for a Special Enrollment Period (SEP) due to specific life events. This could mean paying higher out-of-pocket costs or being locked into a plan that no longer fits your needs.

Assuming Your Current Plan is Still the Best Option

Many Medicare plans change annually, including premiums, deductibles, and coverage rules. What worked well for you in 2024 might not be the most cost-effective choice in 2025. Plan formularies update, meaning your prescriptions could move to a higher cost tier, or your preferred doctors might leave your network. Reviewing your plan each year ensures you’re not paying more than necessary.

What You Should Do Instead

• Compare your current plan with other available options during Open Enrollment.

• Check your plan’s Annual Notice of Change (ANOC) to see what’s different for 2025.

• Look at provider networks and drug formularies to confirm your doctors and prescriptions are still covered affordably.

Overlooking Changes in Medicare Costs for 2025

Medicare costs typically increase each year. For 2025, the standard Medicare Part B premium is $185 per month, and the Part B deductible has risen to $257. Part D plans also have an out-of-pocket cap of $2,000 for prescription drugs, eliminating the previous coverage gap. If you’re not paying attention to these updates, you might be surprised by higher costs or coverage gaps in the new year.

How to Stay on Top of Cost Changes

• Review Medicare’s cost updates for the upcoming year to anticipate any changes in premiums, deductibles, and copays.

• Consider how the new Part D out-of-pocket cap may impact your prescription drug spending.

• If you’re on a fixed income, explore Medicare Savings Programs (MSPs) or Extra Help to lower your costs.

Failing to Check for Prescription Drug Coverage Updates

Prescription drug coverage can shift each year, with medications moving to higher cost tiers or being dropped entirely from your plan’s formulary. Ignoring these changes could leave you paying significantly more for your medications in 2025.

How to Protect Yourself

• Use Medicare’s Plan Finder tool to compare drug costs under different plans.

• Review the updated formulary for your plan to ensure your prescriptions are still covered.

• If costs have increased, explore options like mail-order pharmacies or generic alternatives.

Ignoring Medicare Advantage Plan Changes

Medicare Advantage (Part C) plans offer various benefits, but coverage, provider networks, and out-of-pocket costs change yearly. Some plans may drop benefits such as dental, vision, or hearing coverage, while others may increase copays or limit provider choices. Failing to check these updates can leave you with unexpected costs or reduced coverage.

What You Need to Do

• Review your plan’s Evidence of Coverage (EOC) to see what’s changed for 2025.

• Confirm your doctors and specialists are still in-network to avoid surprise bills.

• Assess whether supplemental benefits like fitness programs, transportation, or meal delivery still meet your needs.

Not Considering How Medicare Works with Other Coverage

If you have employer coverage, retiree benefits, or Medicaid, you must understand how Medicare interacts with these plans. Making changes without considering the impact can lead to unexpected costs or even loss of coverage. For example, if you enroll in a Medicare Advantage plan while still covered under a retiree health plan, you may lose those retiree benefits permanently.

Steps to Take

• Speak with your benefits administrator to understand how Medicare fits with your existing coverage.

• If you have Medicaid, ensure it will continue to work alongside Medicare without disruption.

• If you’re still working, check whether your employer plan is considered creditable coverage for Medicare Part D.

Making an Informed Choice Before Medicare Open Enrollment Ends

Medicare Open Enrollment isn’t just about maintaining coverage—it’s about making sure you’re getting the best value for your money. By avoiding these six costly mistakes, you can ensure you have the right coverage for your health needs and budget in 2025.

If you’re unsure about your options, speaking with a licensed agent listed on this website can help you navigate the process and find the best plan for your situation.