Medicare Open Enrollment: Here's What You Need to Know
The annual Medicare Open Enrollment Period is October 15th through December 7th each year. During this time, Medicare beneficiaries can make changes to their Medicare health or prescription drug insurance coverage. Changes made during Open Enrollment take effect on January 1 of the following year. That means any changes made from October 15 through December 7 take effect January 1, 2025.
All Medicare beneficiaries should have received the 2025 Medicare & You Handbook in October. The handbook includes a summary of Medicare benefits, provides answers to Frequently Asked Questions, and lists available health and drug plans in Pennsylvania. In addition, Medicare beneficiaries should receive their Annual Notice of Change (ANOC) from their current health or drug plan by September 30th. The ANOC includes detailed information about changes in costs and coverage for 2025. If a Medicare plan will not continue in 2025, plan enrollees should receive a notice by early October stating their plan will be ending on December 31st.
Medicare Advantage and Part D Plan Marketing
In conjunction with the start of the Medicare Open Enrollment Period, Medicare Advantage and Part D plans can begin marketing 2025 plan offerings on October 1st. Medicare beneficiaries should be aware of high-pressure sales tactics, aggressive marketing, as well as TV ads that overpromise the benefits people can get. Anyone with concerns about Medicare marketing, fraud, abuse, or scams can call Pennsylvania’s Senior Medicare Patrol program at 1-800-356-3606.
Medicare Plan Finder Tool
Medicare.gov's Plan Finder Tool is an excellent and easy way to find and compare the available Medicare health plans as well as prescription drug plans. By creating an account, Medicare beneficiaries can even see personalized details about their current coverage, Extra Help status, and what they would pay for prescriptions under each plan. Additionally, beneficiaries can enter their prescription drugs and preferred pharmacies into the tool to find out what their costs would be under each plan in their zip code. An email address is not required to set up an account.
PA MEDI Helps Medicare Beneficiaries Compare Plan Choices
Medicare beneficiaries should review their plan options every year during the Open Enrollment Period, however, navigating plan options can be confusing and overwhelming. Pennsylvania Medicare Education and Decision Insight (PA MEDI) can help people compare their plan choices. PA MEDI Counselors offer free, unbiased counseling about Medicare health and drug coverage options.
Medicare beneficiaries who need assistance reviewing and understanding their plan options are encouraged to call PA MEDI at 1-800-783-7067. Click here for more information about PA MEDI, to view PA MEDI events and find local contact telephone numbers.
A Note About Important Inflation Reduction Act (IRA) Changes for 2025
The Inflation Reduction Act (IRA) brings some substantial changes to Medicare Part D that will take effect in 2025. Part D enrollees will now have an out-of-pocket spending cap of $2,000 for plan year 2025. In addition, the coverage gap has been eliminated. Part D plans will also offer a new payment option called the Medicare Prescription Payment Plan (MPPP) that allows enrollees to spread their prescription drug costs over the course of the year.
These changes impact Medicare beneficiaries who do not qualify for Extra Help since Extra Help already limits out-of-pocket costs and eliminates the coverage gap.
