Medicare’s Open Enrollment Period Ends This Week: What You Need to Know
Make Sure You Have Access to Preferred Providers
Beneficiaries may choose to go with original Medicare — Parts A and B with the option to add Part D prescription drug coverage — or private Medicare Advantage plans. With original Medicare, you can see any doctor in the country who accepts Medicare, so access is not an issue. However, with Medicare Advantage plans, there are provider networks that limit the choice of doctors and hospitals from which a beneficiary may choose. It’s best to check — not assume — that the doctors you want to see will be covered by your plan.
Check if Your Prescription Drugs are Covered
Starting in 2025, there’s a $2,000 annual out-of-pocket cap on prescription drug costs through Medicare Part D. That change is due to the Inflation Reduction Act, a federal law enacted in 2022. Consequently, insurance will pay more for about 8% of people who take expensive prescription medications, but they may look for ways to get their money back for the remaining 92%, Moeller said.
Pay Attention to Your Out-of-Pocket Costs
Open enrollment provides an opportunity for beneficiaries to manage how much their overall out-of-pocket costs — including premiums, deductibles, and coinsurance — may increase in 2025. "Make sure that you have manageable out-of-pocket expenses for the year," Moeller said.
Medicare Original vs. Advantage: Choice is Personal
Medicare Advantage has received its share of criticism, particularly for restricted access to care and unexpected costs some beneficiaries have encountered. However, experts say the choice between private Medicare Advantage plans and government Medicare original plans is largely personal. "For some people, Medicare Advantage might be the right call," Moeller said.
You May Still Be Able to Make Changes After Dec. 7
In some cases, beneficiaries may still be able to make changes after the official Dec. 7 end of Medicare open enrollment. Medicare Advantage has its own special open enrollment period that will start on Jan. 1 and last through the first quarter. During that time, Medicare Advantage beneficiaries may switch to a different Medicare Advantage plan, opt for original Medicare or enroll in a standalone Part D drug plan.
Frequently Asked Questions
Q: What is the deadline for Medicare’s open enrollment period?
A: The deadline is Dec. 7.
Q: Can I still make changes after Dec. 7?
A: In some cases, yes. Medicare Advantage has its own special open enrollment period, and beneficiaries may also qualify for special enrollment periods due to life-changing events.
Q: How do I choose the right Medicare plan for me?
A: Start by evaluating your needs and priorities. Consider factors such as access to preferred providers, prescription drug coverage, and out-of-pocket costs. Use online resources, such as Medicare.gov, to compare plans and get free advice from trained counselors.
Q: What is the difference between Medicare original and Medicare Advantage?
A: Medicare original is government-run, while Medicare Advantage is a private plan. Medicare Advantage plans often have provider networks, which can limit access to care, while original Medicare does not. However, Medicare Advantage plans may offer additional benefits, such as hearing, vision, and dental coverage.
