Medicare Open Enrollment: Last-Minute Tips for a Smart Choice

As the Medicare open enrollment deadline approaches on Dec. 7, beneficiaries are urged to take a few minutes to review their health and drug plans for the upcoming year. This final stretch is an ideal opportunity to make sure you have the best coverage for your needs. Here, we outline some last-minute tips to help you make an informed decision.

First and foremost, be aware of the significant changes happening to Medicare this year, especially for Part D prescription drug coverage. The out-of-pocket limit for drug expenses is now $2,000, down from $3,300 to $3,800 in 2024. This cap applies to stand-alone Part D and Medicare Advantage plans with drug coverage. However, insurance companies may look for ways to recoup costs, potentially leading to higher co-pays or deductibles for the remaining 92% of beneficiaries who don't take expensive medications (Cedeno, 2024).

When comparing plans, it's crucial to consider all factors, including premiums, deductibles, and copayments. The average monthly premium for Medicare Advantage plans is decreasing by $1.23 in 2025, but this doesn't necessarily mean it's the best choice for everyone. Take into account your income, expected healthcare usage, and preferred providers to balance affordability and coverage.

Medicare Advantage plans may offer additional benefits, such as dental care or chronic condition coverage. However, there might be changes in formularies, pharmacy networks, and cost-sharing for prescriptions. Review your plan's annual notice of change and use the Medicare Plan Finder tool to compare costs, including premiums, deductibles, and medication costs, for your current plan and others in your area.

Evaluate if your current plan will still provide the best coverage for your prescriptions at your preferred pharmacy in 2025. Input your zip code, drugs, doses, and preferred pharmacies to find plans that cover your prescriptions and offer competitive pricing. Consider the $2,000 annual out-of-pocket cap on prescription drug costs and any changes to formulary coverage, pharmacy networks, or cost sharing.

Lastly, don't forget to check if your preferred doctors and specialists are still in your plan's network. Changes in provider networks can significantly impact your access to healthcare services.

By following these tips and taking the time to review your options, you can make a smart choice for your Medicare coverage in 2025. Don't miss this opportunity to ensure you have the best plan for your needs.