What to Expect During Medicare Open Enrollment (October 15 – December 7)

What to Expect During Medicare Open Enrollment (October 15 – December 7)

Medicare Open Enrollment is a crucial time for millions of beneficiaries across the country. It’s the period when people can review their healthcare coverage, make changes to their plans, and ensure they’re set up for the coming year. Whether you’re new to Medicare or have been enrolled for years, it’s essential to stay informed and make the right choices for your health and finances.

In this article, we’ll walk you through everything you need to know about Medicare Open Enrollment, from key dates to steps you should take, and some important changes to consider for 2024.

Key Dates for Medicare Open Enrollment

First things first, let’s make sure you’re clear on the important dates:

Open Enrollment Period: October 15 to December 7.
Coverage Changes Become Effective: January 1, 2024.

This seven-week window is your opportunity to adjust your Medicare coverage if needed. If you’re happy with your current plan, you don’t have to do anything, but it’s always smart to review your options. New plans and benefits come out every year, so even a quick look can save you money or provide better coverage for your healthcare needs.

What You Can Do During Medicare Open Enrollment

During the open enrollment period, you have several options. Here’s what you can do:

Switch from Original Medicare to a Medicare Advantage Plan (Part C)
If you’re currently enrolled in Original Medicare (Parts A and B) and think a Medicare Advantage Plan (Part C) may offer better coverage for your needs, now is the time to make that switch. Medicare Advantage plans often include additional benefits such as vision, dental, hearing, and even fitness programs that Original Medicare doesn’t cover.
Switch from a Medicare Advantage Plan back to Original Medicare
If you’ve been on a Medicare Advantage Plan and want to return to Original Medicare, you can do so during this window. However, if you go this route, it’s important to remember that you might need a separate Medicare Part D plan for prescription drug coverage and, potentially, a Medigap plan to help with out-of-pocket costs.
Change from one Medicare Advantage Plan to another
If you’re already on a Medicare Advantage Plan but want to switch to a different plan (maybe one with a better network of doctors or lower costs), you can make that change during open enrollment. Be sure to compare your options carefully to ensure you’re getting the most value for your money.
Join or switch a Medicare Prescription Drug Plan (Part D)
Prescription drug plans can change their formularies (the list of covered drugs) every year. During open enrollment, it’s a good idea to check your current plan and compare it to others, especially if your prescription needs have changed. You can switch to a new Part D plan if another plan offers better coverage for your medications at a lower cost.
Drop your Part D coverage
If you no longer need prescription drug coverage, you can also drop your Part D plan during this period. However, it’s important to consider that if you go without Part D or creditable drug coverage for more than 63 days, you may face a late enrollment penalty if you decide to re-enroll in a plan later.

Key Steps to Take During Open Enrollment

Now that you know what changes you can make, here’s how to approach the process:

Review Your Current Coverage
Start by looking over your current Medicare plan. Are you happy with
your coverage? Are your prescriptions still covered at a reasonable price? Is
your doctor still in the network? If you’re using a Medicare Advantage Plan,
have your out-of-pocket costs increased? Even if you think you’re satisfied
with your plan, it’s worth reviewing your options to see if something better is
available.
Compare Available Plans
Medicare offers an online plan comparison tool on Medicare.gov that makes it
easy to evaluate different Medicare Advantage and Part D plans. You can enter
your prescription drugs and preferred pharmacies, and the tool will show you
estimated costs for each plan available in your area. This helps you see
side-by-side comparisons of premiums, copays, and drug costs.
Consider the “Extras”
Medicare Advantage plans often include extra benefits like vision, dental, hearing, and even wellness programs. If these benefits matter to you, factor them into your decision-making process. Keep in mind, however, that these plans often have limited networks of providers, so make sure your preferred doctors and hospitals are included.
Check for Plan Changes
Even if you like your current plan, remember that plan details change each year. For example, a plan might raise premiums or copays, drop specific drugs from the formulary, or reduce coverage for certain services. Be sure to review your Annual Notice of Change (ANOC), which should have arrived in your mailbox by late September. This document highlights any changes in your plan’s coverage or costs for the coming year.
Contact Your Healthcare Providers
If you’re considering switching to a new Medicare Advantage or Part D plan, check with your doctors and pharmacies to make sure they are still in-network or accepting your new plan. This is especially important if you have any specialized or ongoing healthcare needs.

Changes to Medicare for 2025

Each year, Medicare makes changes to its policies, benefits, and costs. Here are some changes to look out for in 2025:

Part B Premium and Deductible Adjustments
The standard Part B premium often sees adjustments each year. For 2025, be prepared for a potential increase. Keep an eye on the official announcement from the Centers for Medicare & Medicaid Services (CMS) regarding the finalized premiums and deductibles for the coming year.
Expanded Telehealth Coverage
Telehealth became a more prominent part of Medicare coverage during the pandemic, and it’s here to stay for many services. Check to see how your plan covers telehealth appointments, as this may vary between Original Medicare and Medicare Advantage Plans.
Insulin Cost Caps
In 2025, Medicare will continue implementing the insulin cost cap under the Inflation Reduction Act. This cap limits the monthly cost of insulin for people on Medicare to $35, which could save you a significant amount if you require insulin for diabetes management.
Newly Approved Medicare Advantage Benefits
Medicare Advantage plans often expand the list of additional benefits, such as home-delivered meals, transportation to medical appointments, and even home modifications for safety. Be sure to review the plans available in your area to see what new benefits they may offer.

The key takeaway? Don’t miss out on this chance to optimize your Medicare coverage. The changes you make during open enrollment will go into effect on January 1, 2025, so take action now to secure the right healthcare plan for the coming year.

Need more information? Just give me a call at 239-682-8567; it doesn’t cost you a thing to speak with me and get answers right away as this critical deadline approaches.

I look forward to speaking with you soon!

Michele Sanchez
Michele Sanchez Insurance Agency (239) 682-8567