Medicare Open Enrollment – What Do I Need to Know?
The annual Medicare Open Enrollment period runs from October 15 to December 7, 2025. This is your primary chance each year to make changes to your Medicare health or drug coverage—whether you’re evaluating new plan features or responding to changes in your healthcare needs.
Key Dates and Eligibility
- Open Enrollment: October 15 – December 7, 2025.
- Changes Take Effect: January 1, 2026.
- Who Can Participate: Only individuals already enrolled in Medicare. (If you’re approaching age 65, your Initial Enrollment Period spans 3 months before and after your 65th birthday. Missed that window? The General Enrollment Period runs January 1 – March 31, with penalties possible for late enrollment.)
How to Compare Plan Options
- Online: The official Medicare Plan Finder remains the most reliable resource to explore and compare Medicare Advantage (Part C) and Part D prescription drug plans.
- Phone: Call 1-800-MEDICARE (1-800-633-4227) for direct assistance from a federal representative.
- Local Help: The State Health Insurance Assistance Program (SHIP) offers free, unbiased support specific to your state.
What Can You Change During Open Enrollment?
During this period, you may:
- Switch between Original Medicare and a Medicare Advantage (Part C) plan
- Change from one Medicare Advantage plan to another
- Join, drop, or change a Medicare Part D prescription drug plan
Any changes you make will begin on January 1, 2026.
Spotlight on Medigap (Supplemental Medicare)
Medigap (Medicare Supplement Insurance) helps cover out-of-pocket expenses not paid by Original Medicare (Parts A & B), such as deductibles, coinsurance, and copays. You can only purchase Medigap if you are enrolled in Original Medicare—Medigap is not compatible with Medicare Advantage. The best time to purchase is during your first six months of Medicare Part B enrollment, ensuring you’re not denied for pre-existing conditions or charged higher premiums based on health status.
Reviewing Medicare Advantage (Part C) Plans
Medicare Advantage combines hospital (Part A) and medical (Part B) coverage and often includes prescription drug coverage (Part D), plus extras like dental or vision. Note that these plans may feature network restrictions or annual changes in costs and coverage. Annual review is essential; you can also use the Medicare Advantage Open Enrollment Period (Jan 1 – Mar 31) for certain additional changes.
Don’t Forget About Medicare Part D
Prescription drug plans often update their formularies, premiums, and pharmacy networks each year. It’s important to review your options during open enrollment—even if you’re satisfied currently. Penalties for late enrollment in Part D remain in place, so timely evaluation is crucial.
Action Items for 2025
- Shop carefully: Compare your current health and prescription drug coverage to other available options.
- Confirm providers and medications: Make sure your doctors and drugs remain covered by your selected plan into 2026.
- Address Late Enrollment Penalties: If you’re new and missed your prior enrollment windows, consider options now to minimize surcharges.
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