2025 Medicare Open Enrollment Period: Key Dates and Changes to Know

The Medicare Open Enrollment Period for 2025 runs from October 15, 2024, to December 7, 2024.

This is a critical time for Medicare beneficiaries to review their current coverage and make necessary adjustments for the upcoming year. Whether you are enrolled in Original Medicare, Medicare Advantage, or a Part D Prescription Drug Plan, this enrollment window is your opportunity to assess whether your current plan still meets your healthcare and budgetary needs.

Key Options During Open Enrollment

During the 2025 Medicare Open Enrollment Period, you can:

• Switch from Original Medicare (Part A and Part B) to a Medicare Advantage Plan (Part C) or vice versa.
• Change from one Medicare Advantage Plan to another (with or without drug coverage).
• Join, switch, or drop a Medicare Part D Prescription Drug Plan.
• Switch from one Medicare Part D Prescription Drug Plan to another to find better coverage for your prescriptions.

It’s essential to carefully review your Annual Notice of Change (ANOC) document from your current plan provider. This document outlines changes to your coverage, including premiums, drug formularies, co-pays, and other important details for 2025.

Significant Changes for 2025: Medicare Part D Maximum Out-of-Pocket Cap

A major change coming in 2025 is the introduction of a $2,000 maximum out-of-pocket (MOOP) limit for Medicare Part D plans. This change is part of the Inflation Reduction Act, which aims to lower drug costs for Medicare beneficiaries. We made a short video to explain these changes, which you can view below.

Currently, there is an $8000 cap in 2024 on how much beneficiaries can spend on prescription drugs, which has left many seniors with significant out-of-pocket expenses once they reach the catastrophic coverage phase of Part D. In 2025, once you hit $2,000 in out-of-pocket spending for covered prescription drugs, you will no longer be required to pay co-pays or coinsurance for the remainder of the year. This change is expected to provide significant financial relief to millions of Medicare beneficiaries who face high drug costs.

Why the MOOP Is Important

The $2,000 out-of-pocket maximum is a significant improvement for those who rely on expensive medications. After reaching this threshold, all additional drug costs will be fully covered by your Medicare Part D plan for the remainder of the year. This means that, for the first time, Medicare enrollees can predict and limit their annual prescription drug spending, offering peace of mind and financial predictability.

If you're someone who has been burdened by high medication costs in the past, this is a good time to review your current Medicare Part D plan and compare it with others to ensure you're getting the best value. Many plans vary in terms of premiums, drug formularies, and preferred pharmacy networks, so switching plans during Open Enrollment could save you money in both premiums and out-of-pocket costs.

How to Prepare for Medicare Open Enrollment

1. Review Your Current Plan: Examine your ANOC to understand changes in premiums, deductibles, and prescription drug coverage for 2025. If your current plan is still a good fit, you don't need to take any action, as coverage will automatically be renewed.
2. Compare Your Options: Use the Medicare Plan Finder tool on Medicare’s official website to compare Medicare Advantage Plans and Part D Prescription Drug Plans in your area. Consider factors such as coverage for your specific medications, co-pays, premiums, and overall costs.
3. Seek Local Guidance: Medicare can be complex, and plan options may change from year to year. Contact a licensed Medicare agent near you.

Final Thoughts

The 2025 Medicare Open Enrollment Period offers an excellent opportunity to review your healthcare and prescription drug coverage. With the introduction of the $2,000 out-of-pocket cap for Medicare Part D, many beneficiaries will experience significant savings on prescription drugs. Make sure to review all available options carefully and take advantage of this period to ensure your Medicare plan suits your medical needs and budget for 2025.

Kevin Truebenbach of Transition Health Benefits is a Medicare Agent Licensed in AR, AZ, CO, DC, DE, FL, GA, IA, IL, IN, KS, KY, LA, MD, MI, MN, MO, MS, MT, NC, NE, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI and WV. Licensed Medicare agent for over 20+ years and has 600+ positive Google Reviews.