
Our founder Susan Moore contributed the following update for Medicare planning
The Medicare Advantage Open Enrollment Period (MA OEP) is currently underway and runs from January 1 to March 31, 2025.
This is an important time for individuals enrolled in Medicare Advantage plans to review their coverage and make any necessary changes.
What is Different about the 2025 MA OEP?
For the 2025 MA OEP, there are no significant changes to the enrollment process itself. However, it’s important to be aware of broader updates affecting Medicare coverage in 2025:
- Changes in Plan Availability: There is a reduction in the number of Medicare Advantage plans available in 2025. Some insurers that previously offered Medicare Advantage have left the market. Additionally, some healthcare providers have stopped accepting certain Medicare Advantage plans, so it’s critical to verify that your preferred providers are still in-network.
- Adjustments in Premiums and Benefits: While the average monthly premium for Medicare Advantage plans has decreased to $17.00 in 2025 from $18.23 in 2024, some plans may have adjusted their core benefits or reduced supplemental offerings like gym memberships. It’s essential to review any changes to your plan’s benefits and costs.
- Introduction of a $2,000 Out-of-Pocket Cap for Part D: Starting in 2025, Medicare Part D plans will implement a $2,000 annual cap on out-of-pocket prescription drug expenses. Once you reach this limit, you won’t have to pay additional costs for covered drugs for the remainder of the year.
What You Can Do During MA OEP
During this period, if you are currently enrolled in a Medicare Advantage plan, you have the following options:
- Switch to a different Medicare Advantage Plan: If your current plan no longer meets your needs, you can change to a different Medicare Advantage plan.
- Drop your Medicare Advantage plan and return to Original Medicare: You can disenroll from your Medicare Advantage plan and switch back to Original Medicare (Parts A and B). You can also enroll in a standalone Part D prescription drug plan if needed. Note that in most states when someone switches to Original Medicare from Medicare Advantage, insurers can require medical underwriting in order to purchase a Medigap (Medicare Supplement) policy. This means the insurer can deny Medigap coverage if you have certain health conditions. Four states (CT, MA, ME, and NY) have implemented protections that prohibit underwriting in these situations.
- Adjust Prescription Drug Coverage: If your Medicare Advantage plan includes drug coverage, you can change to another MA plan that better suits your medication needs.
Key Considerations
When evaluating your Medicare Advantage options, here are some factors to consider:
- Provider Network: Ensure your preferred doctors, specialists, and hospitals are included in the network of any plan you are considering.
- Drug Coverage: Check whether your medications are covered and if there are changes to the formulary or pricing.
- Out-of-Pocket Costs: Review premiums, deductibles, and co-pays to understand your total potential expenses.
- Additional Benefits: Some plans offer extra benefits such as vision, dental, hearing, and fitness memberships. Compare these benefits to see if they align with your needs.
Common Questions
- Can I switch plans multiple times during this period? No, you are allowed to make only one change during the MA OEP.
- What if I miss the deadline? After March 31, you generally cannot make changes until the next Annual Enrollment Period (October 15 – December 7), unless you qualify for a Special Enrollment Period due to specific life events.
Next Steps
If you’re considering a change to your Medicare Advantage coverage, we encourage you to act early to avoid delays.
Two important resources for help and more information are the Medicare web site, and a State Health Insurance Assistance Program (SHIP) counselor, available at your local senior center.
-SM