Medicare Fall Open Enrollment 2025
The 2025 Medicare Fall Open Enrollment is upon us, which means your mailbox is likely overflowing with advertisements. Frustrating, right?
And it’s not just your mailbox—every time you turn on the TV, there’s another ad about Medicare plans. For many Medicare beneficiaries, the period from October 15th to December 7th can be the most confusing time of the year.
This post has been updated to reflect the latest information for the 2025 Medicare Fall Open Enrollment.
Every year, many beneficiaries know they need to do something during Medicare Fall Open Enrollment, but they’re often unsure of what exactly that is. The constant barrage of ads on radio and TV can create anxiety, leaving people wondering if they need to make changes or take action.
Don’t worry. In this post, I’ll clarify what the Medicare Fall Open Enrollment is all about. I’ll walk you through what you should be doing each year.
We’ll also cover what you can’t do during Medicare Open Enrollment.
Rest assured, our agency has assisted thousands of beneficiaries just like you during this period last year. We have a wealth of knowledge that can help you, and we’ve even created a checklist to ensure you don’t miss any steps. You can download it here before continuing to read:
What is the Medicare Fall Open Enrollment Period?
Also known as the Annual Election Period, the Medicare Fall OEP was introduced alongside Medicare Part D in 2006. It’s an 8-week window every fall when Medicare beneficiaries can enroll in, switch, or drop their Medicare Advantage and/or Part D drug plans.
Here’s why this period exists: Part D and Medicare Advantage plans submit their benefits for approval to Medicare each year.
This means that the benefits and premiums of your plan might change or increase. Medicare gives you an election period each year to switch plans if you’re unhappy with changes to your current coverage.
In short, since your Part D benefits change annually, you have a chance to change your plan during this election period if you don’t like those changes.
Now, the good news is you don’t have to change your plan if you’re happy with it. In fact, most beneficiaries do not make changes each year. However, you should definitely review the upcoming changes to your plan each September.
How Do I Know if I Need to Make Changes to My Plan?
In September, your Medicare Advantage or Part D plan provider will send you an Annual Notice of Change. Take 15 minutes to review this document. It will inform you if your premium is changing and if there are changes to your copays, drug formulary, or pharmacy networks.
The Annual Notice of Change lists your plan’s changes side-by-side from 2024 to 2025, making it easy to compare.
What Changes Can I Make During Medicare Open Enrollment 2025?
During the Medicare OEP, you have the following options:
-Do nothing, and your current Medicare coverage will automatically renew for 2025.
-Enroll in, leave, or change your Medicare Part D drug plan.
-Switch from Traditional Medicare to a Medicare Advantage plan.
-Switch from a Medicare Advantage plan back to Traditional Medicare.
-Change from one Medicare Advantage Plan to another.
Remember, Part D plans don’t have health questions, so you can switch to another plan as long as you have Medicare A and/or B and live in the plan’s service area.
Medicare Advantage plans only ask one health question about End-Stage Renal Disease, so it’s relatively simple to enroll or switch as long as you don’t have this condition.
Good Reasons to Change Your Plan
Wondering if you should change your Part D or Medicare Advantage plan for 2025? Here are some common reasons to consider switching:
Your plan is dropping a crucial medication next year. The Annual Notice of Change will list any changes to the drug formulary. If a medication you need is no longer covered or is moving to a higher cost tier, you may want to switch to a different plan.
Your Medicare Advantage plan is dropping your doctor from its network. Unlike Medigap plans, Medicare Advantage plans have a network of doctors. If your doctor is leaving the plan’s network, you might want to switch to another plan that includes your doctor.
Your plan’s premium is significantly increasing. While small increases in premium might not be worth the hassle of switching, a large hike in costs could make it worthwhile to shop around.
The important thing is not to overcomplicate it. If you’re satisfied with your current plan and the changes aren’t significant, don’t feel pressured to shop around just because of the constant Medicare ads.
Simply review your Annual Notice of Change to see if any modifications make you want to explore other options. If you need to make changes, don’t hesitate to contact your agent for assistance.
What’s Not Changing for 2025: Your Medigap Plan Benefits
Unlike Part D plans, Medigap (Medicare Supplement) plan benefits are standardized by the federal government and do not change from year to year.
Although your Medigap premium may increase, the benefits themselves remain consistent. Medigap plans have annual rate increases, which occur on your policy anniversary date. For example, if you purchased your policy on January 1st, your renewal occurs every January 1st, with any rate increases reflecting on that date.
Should You Shop Your Medigap Plan During the OEP?
Since your Medigap benefits don’t change, it’s up to you whether you want to shop around during the fall. Some people choose to do so while comparing their Part D plans to tick off both items on their to-do list.
Medigap plans are standardized, meaning they all offer the same benefits regardless of the carrier. If you find a lower premium for the same Medigap plan, it’s safe to switch carriers without worrying about a difference in coverage.
The Medicare OEP Does Not Apply to New Medigap Policies
It’s a common misconception that you can switch Medigap plans during the OEP without health questions, but that’s not true. The OEP applies only to Part D and Medicare Advantage plans, not Medigap plans. Most states require you to answer health questions when applying for a new Medigap plan, and the insurance company can accept or reject your application based on your answers.
For this reason, we refer to the period as the Annual Election Period to avoid confusion among clients.
To summarize:
You can switch Part D plans without health questions.
You can change Medicare Advantage plans with only one health question.
Switching from one Medigap plan to another involves answering a full set of health questions.
Your Medicare Part B Premium Might Also Change in 2025
Every year, the federal government adjusts the Medicare Part B premium, which is linked to the Cost of Living Adjustment in your Social Security benefits. Part B premiums have increased over the years, and new enrollees in 2024 paid a minimum of $174.70/month. This amount will likely change for 2025, depending on factors like your household gross income.
Who Can Help You with Medicare Open Enrollment 2025?
We know this process can be confusing, which is why agents like us are here to help. Be sure to download our checklist to ensure you don’t miss any steps. If you’ve reviewed your ANOC letter and need assistance with changing your drug plan, call us for guidance on how to enroll in a new Part D plan.
For those interested in shopping around for a Medigap policy, give us a call at 1-608-784-8969. We can assist with Part D after helping with your Medigap needs.
Don’t forget, you can also reach Medicare directly at 1-800-MEDICARE or use the Drug Plan Finder Tool on Medicare’s website for free assistance.
Have a question about the 2025 Medicare Fall Open Enrollment Period? Feel free to post it below, and I’ll be happy to help.
Key Takeaways
-You can enroll, disenroll, or change your Medicare Advantage plan or Part D plan during the Fall Open Enrollment window from October 15th to December 7th.
-To determine if you need to make any changes, you can review your current plan’s Annual Notice of Change Letter.
-The Fall Open Enrollment has nothing to do with Medigap plans.