Key Takeaways

• The 2025 Medicare Open Enrollment period runs from October 15 through December 7, giving you a limited time to review and change your coverage.

• Making a plan change this fall could reduce your annual out-of-pocket costs, improve your access to care, or provide better prescription coverage for the year ahead.

Why This Annual Window Matters More Than Ever

Each fall, Medicare gives you the opportunity to reassess your coverage. From October 15 to December 7, you can review, compare, and switch your Medicare health or drug plan. This window is known as the Annual Enrollment Period (AEP), and in 2025, it carries more weight than ever before.

With the rising cost of healthcare, changes to prescription drug rules, and the introduction of new plan benefits, skipping this opportunity could mean paying more than you need to. If your health needs have changed—or even if they haven’t—your plan might not offer the best value for the upcoming year.

What You Can Do During Fall Enrollment

The fall Open Enrollment period allows you to:

• Switch from Original Medicare to a Medicare Advantage plan

• Switch from Medicare Advantage back to Original Medicare

• Change from one Medicare Advantage plan to another

• Join, drop, or switch Medicare Part D prescription drug plans

These changes go into effect on January 1, 2026.

Even if you’re satisfied with your current plan, you should review any upcoming changes to make sure it still meets your needs for the new year.

Major Changes in 2025 You Should Know About

2025 brings a few important changes that may impact your Medicare coverage and costs:

1. Part D Out-of-Pocket Drug Cap

The introduction of a $2,000 cap on out-of-pocket prescription drug costs under Part D means you could save significantly if you take high-cost medications. If your current plan doesn’t include this benefit—or doesn’t manage costs well—switching could help you avoid overspending.

2. Prescription Payment Plan Option

New in 2025, Medicare Part D enrollees can opt into a payment program that allows prescription costs to be spread out over the year. This change may benefit you if you prefer predictable monthly payments over large out-of-pocket costs early in the year.

3. Mid-Year Benefit Notifications

Medicare Advantage plans must now send you a mid-year summary of unused supplemental benefits between June 30 and July 31. This means you’ll have better insight into what you’re not using—and whether another plan would better match your health needs and budget.

4. Changes in Supplemental Benefits Availability

Supplemental benefits, such as vision, dental, hearing, transportation, and over-the-counter allowances, are still widely offered, but availability has declined in 2025 compared to 2024. You should carefully check which benefits your plan offers and whether another plan provides more value.

Reviewing Your Annual Notice of Change (ANOC)

If you’re already enrolled in a Medicare Advantage or Part D plan, you should have received an Annual Notice of Change (ANOC) in September. This document lists all the upcoming changes in your plan’s:

• Premiums

• Deductibles

• Copayments

• Provider network

• Drug formulary

• Benefits

Don’t ignore this notice. Comparing it to your current healthcare usage can help determine whether you should switch plans.

How to Know If You Should Make a Change

Ask yourself the following questions during Open Enrollment:

• Have your prescription needs changed over the past year?

• Have your doctors left your plan’s network?

• Are you paying more for services or medications?

• Are you using supplemental benefits, or are they going unused?

• Do you need more comprehensive dental, vision, or hearing coverage?

If you answered yes to any of the above, it may be time to explore other plan options. Even small plan differences can add up to hundreds of dollars in yearly savings.

Why You Shouldn’t Assume Your Plan Will Be the Same

Even if your own health hasn’t changed, your plan probably has. Insurers adjust coverage annually, often in ways that affect your costs and access. For instance:

• Your preferred pharmacy may no longer be in-network.

• Drugs you take might have moved to a more expensive tier.

• Copays for services may have increased.

• A benefit you rely on may have been removed.

What worked for you in 2024 might not be your best option in 2025.

How to Compare Plans Effectively

Start by gathering a list of your current medications, providers, and healthcare usage. Then consider these factors as you evaluate plans:

• Monthly premiums and annual deductibles

• Drug formulary coverage and pharmacy preferences

• Out-of-pocket maximums for Medicare Advantage plans

• Availability of specialists in-network

• Travel needs and provider access when out-of-state

• Value of supplemental benefits and whether you use them

Online tools and plan comparison checklists can help, but you don’t have to do it alone.

Key Enrollment Dates for 2025

• October 15 – December 7, 2025: Medicare Open Enrollment period. You can switch plans or make other coverage decisions.

• January 1, 2026: New coverage begins.

If you make no changes during the AEP, your current coverage will automatically renew—but that doesn’t mean it’s still your best option.

Mistakes to Avoid This Fall

Choosing the wrong plan—or failing to act at all—can result in higher costs and less coverage. Watch out for these common errors:

• Ignoring the ANOC

• Assuming last year’s plan still fits your needs

• Not checking drug formulary changes

• Overlooking changes in provider networks

• Missing the enrollment deadline

Being proactive during this window could prevent financial strain and healthcare access issues throughout 2026.

Coordinating Medicare with Other Coverage

If you have retiree benefits, VA coverage, or other insurance, it’s important to understand how your Medicare choices interact with them. For example:

• Enrolling in a Part D plan might affect drug coverage under other programs

• Medicare Advantage enrollment may limit coverage outside of network areas

• Employer or union plans might require you to stay in Original Medicare

Speak with your benefits administrator or a licensed agent to avoid unintentional disruptions in care.

What Happens If You Miss the Window

If you don’t make changes by December 7, your current plan will carry into 2026. In most cases, you won’t be able to make changes again until the next Annual Enrollment Period—unless you qualify for a Special Enrollment Period (SEP) due to specific life events, like:

• Moving to a new address

• Losing other coverage

• Becoming eligible for Medicaid

• Moving into or out of a care facility

These exceptions are limited, and the timing is strict, so it’s best to act during Open Enrollment when you have full control.

It’s Not Just About Savings—It’s About Peace of Mind

Choosing the right Medicare plan isn’t just a financial decision. It affects your ability to get timely care, continue seeing your providers, and afford prescriptions. The right plan could mean less stress when unexpected health issues arise.

Taking time this fall to compare your options can offer more than cost savings—it can protect your health and independence throughout the year.

Let 2025 Be the Year You Take Control of Your Medicare Coverage

This fall’s Medicare Open Enrollment period offers you a fresh chance to reassess your coverage, reduce your expenses, and feel more secure in your health care choices. The steps you take now could make all the difference in how well your plan serves you in 2026.

To make the most of this window, speak with a licensed agent listed on this website. You don’t have to make these decisions alone—and expert guidance can help you feel confident about the path you choose.