Preparing for Medicare Open Enrollment: What to Know and How to Choose
As Medicare Open Enrollment begins on October 15 and lasts until December 7, it’s an ideal time for those aging in place to review their current healthcare plan. Medicare plans often change yearly, so it’s crucial to ensure that your coverage still aligns with your health needs and budget.
Key Enrollment Options
During this period, you can:
Switch Medicare Advantage Plans: If you have Medicare Advantage, you can switch to a different Medicare Advantage Plan or return to Original Medicare.
Adjust Part D Prescription Drug Plans: Original Medicare enrollees can join, drop, or switch drug plans.
Review Drug Coverage Needs: New for 2025, Medicare Part D plans will have a $2,000 cap on out-of-pocket costs and allow monthly payment distribution, which can ease the financial burden on medications.
Your new choices will go into effect on January 1 of the upcoming year.
Why Reviewing Your Plan is Important
Research shows that 70% of Medicare beneficiaries didn’t compare plans in recent years. By reviewing your options, you may find plans with better coverage or lower out-of-pocket costs, potentially saving you hundreds of dollars. Changes in premiums, coverage, or the list of covered drugs (called the formulary) can affect your medical and drug expenses.
Tips for Choosing the Right Plan
Check for Coverage Changes: Look over your “Annual Notice of Change” to see if premiums or coverage are different. Verify that any necessary medications and services are still included in your plan.
Use Medicare’s Plan Finder Tool: Available at Medicare.gov, this tool provides side-by-side comparisons of available plans, including costs and quality ratings.
Get Help from SHIP: The State Health Insurance Assistance Program (SHIP) offers free, unbiased assistance for comparing plans and reviewing coverage. Every state has SHIP offices, and they’re a valuable resource for seniors and their families.
Financial Assistance Programs
Consider whether you qualify for Medicare Savings Programs (MSP) or the Low-Income Subsidy (LIS):
Medicare Savings Programs help pay premiums and other Medicare expenses, yet less than half of eligible individuals are enrolled.
Low-Income Subsidy (LIS) can help cover prescription drug costs, offering average savings of almost $500 per month. Check eligibility using the BenefitsCheckUp website or call 844-902-2425 for assistance.
Important Reminders
Medicare.gov and 1-800-MEDICARE (1-800-633-4227) provide 24/7 support during Open Enrollment.
It’s important to review your needs and any available assistance programs to stay financially comfortable in the coming year.
