If you’re on Medicare or soon to be, the open enrollment period each fall is one of the most important financial and Health decisions you make all year. For 2025, there are some key changes and updates that could make a difference in both your premiums and out-of-pocket costs. Here’s what you should know and what is new for the annual open enrollment period. $2,000 Out-of-Pocket Cap on Prescription Drugs
All Medicare plans with prescription drug coverage will set a limit on what you can pay out of pocket for covered drugs. This means that no matter how expensive your medication costs are, you’ll never pay more than that limit in a year for medications covered by your plan. It provides important protection for retirees who often have multiple prescriptions. Lower or Leveling Premiums for Part D & Medicare Advantage
The average premiums for Medicare Advantage and Part D plans are expected to decrease or remain steady in many areas. This could lead to savings if you’re thinking about switching plans. More Transparency Around Supplemental Benefits
A new requirement states that Medicare Advantage plans must send out a personalized “mid-year unused benefits” notification. This informs you which extra benefits in your plan you haven’t used (vision, dental, hearing, fitness, etc.), what they cost, and how to access them. It ensures you’re getting all the value the plan provides. What Stays the Same - Open Enrollment Period Dates: October 15, 2025, through December 7, 2026. Changes made during this period take effect on January 1, 2026.
- Medicare Advantage Open Enrollment: for those already enrolled in an Advantage plan runs from January 1 through March 31. During this period, you can make limited changes.
What You Should Do - Review your current plan and identify your actual prescription costs.
- Compare alternatives to see if you can get better drug coverage and a lower cost.
- Use the mid-year benefits notice to check that you’re not letting supplemental benefits go unused.
- Watch for changes in plan networks, formularies, and benefits.
These changes for 2025/2026 open enrollment provide extra protection and potential savings. However, the actual benefit will depend on your healthcare needs, prescription choices, and how you use your benefits. Taking time during the open enrollment period to compare plans, review your coverage, and use all available benefits can lead to savings. If you need help or have questions, please reach out! |
