Medicare’s Open Enrollment is just over a month away, and runs October 15 through December 7. It is the time of year when you can make certain changes to your Medicare coverage. The last change you make will take effect on January 1. It’s important to take action during Medicare’s Open Enrollment to make sure your coverage will meet your needs in 2025.
What Changes Can You Make During Medicare’s Open Enrollment?
During Open Enrollment, you can make certain changes to your health insurance coverage, including adding, dropping, or changing your Medicare Advantage and Part D coverage. You can make as many changes as you want during this period, but only your last coverage choice will take effect in January. The changes you can make include joining a new Medicare Advantage Plan or Part D prescription drug plan, switching from Original Medicare to a Medicare Advantage Plan, and switching from a Medicare Advantage Plan to Original Medicare.
If you are switching to Original Medicare, note that you may have limited options for purchasing a Medigap policy to help with your out-of-pocket costs. Contact your local Health Insurance Counseling and Advocacy Program (HICAP) to discuss your rights to a Medigap policy.
Before making a decision about your 2025 coverage, consider the Medicare health and drug plan options in your area. You may be able to receive the same or better health or drug coverage at a more affordable price. For example, even if you are satisfied with your current Medicare Advantage or Part D plan, you should check to see if there is another plan in your area that offers the same health or drug coverage at a better price.
Review your current Medicare health and drug coverage
You will receive a lot of mail during Medicare’s Open Enrollment, so it is important to know which mailings include information about your current coverage and how it may change in 2025. Regardless of whether you have Original Medicare or a Medicare health plan, you should consider your access to health care providers and pharmacies you want to use, your access to benefits and services you need, and the total costs for insurance premiums, deductibles, and cost-sharing amounts.
If you have Original Medicare, visit Medicare.gov or read the 2025 Medicare & You handbook to learn about Original Medicare benefits for 2025. Note: the 2025 version is not yet available.
If you have a Medicare Advantage Plan or a stand-alone Part D plan, read your plan’s Annual Notice of Change, or ANOC, and Evidence of Coverage, or EOC. You should receive it no later than September 30. These notices list any changes for your plan in 2025.
Pay special attention to any changes in the plan’s costs, the plan’s benefits and coverage rules, and the plan’s formulary. The formulary is the list of drugs your plan covers. Make sure that your drugs will still be covered next year and that your providers and pharmacies are still in the plan’s network. If you are unhappy with any of your plan’s changes, you can change your coverage.
How to make changes to your Medicare health and drug coverage
You can call 1-800-MEDICARE to make coverage changes by phone or visit Medicare.gov to compare options and enroll in some plans online. You can also contact plans directly to learn about the services they cover or to enroll. Confirm everything that a plan tells you before making a final decision and get everything in writing. Before joining, call your doctors to make sure that they are in the provider network for the plan you want to join.
If you want one-on-one help reviewing your options or making changes, contact your local HICAP at 1-800-434-0222. HICAPs are funded by the government to provide trusted, unbiased Medicare counseling.
Protect Yourself From Marketing Violations & Misleading Marketing
During Open Enrollment, health insurance companies reach out to people in numerous ways, like television commercials, radio ads, events, mailings, phone calls, and texts. It can be overwhelming and hard to navigate, though the Centers for Medicare & Medicaid Services (CMS) has marketing rules for Medicare Advantage and Part D plans to protect you and your loved ones from aggressive or misleading marketing. Knowing the rules and red flags can help you make the best choices for yourself during Open Enrollment and prevent enrollment fraud.
Plans are allowed to send you mail. They can also email or call you about other health plans and products, as long as you are already a plan member and haven’t asked them not to call or email. emails and/or direct mailings, but they are not allowed to call you or visit you in person to market their products without your permission. Plans who call or send emails must provide an opt-out option for people who no longer wish to receive them.
Watch out for people who:
- Pressure you to join their plan
- Tell you they represent Medicare or are calling on behalf of Medicare
- Visit you at home without your permission
- Offer free consultations only to people with Medicare and ask for your Medicare number
- Inform you that you will lose your Medicare benefits unless you sign up for a certain plan
- Require you to provide personal information or try to sell you a plan at an educational event (Note that contact information provided for raffles or drawings may only be used for that purpose.)
Before you enroll in a plan, make sure you understand what the plan covers, how it affects your Medicare benefits and other health benefits (like Medicaid or your retiree/union coverage), and whether it covers the drugs you need. Contact a plan directly to confirm if it will cover certain services for you, and make sure that you get everything in writing. You can also call your local HICAP for unbiased answers to coverage questions.
Remember that an agent or broker should never pressure or mislead you into joining a plan. If you feel an insurance agent has potentially violated Medicare’s marketing rules, you should save all documents (such as an agent’s business card or marketing materials) or other suspicious information, such as recorded messages.
Report any marketing violations to our California Senior Medicare Patrol at 1-855-613-7080. Our California SMP can help you review the incident, report it to the correct authorities, and continue spotting marketing violations.
For more information, download and share:
- Our Novella: Medicare Marketing Abuse Alert available in English and Spanish
- Handout: Medicare’s Open Enrollment Period
