A: Medicare Open Enrollment is a set time each year when anyone who has Medicare health insurance can change their health plan and their prescription drug plan. Open Enrollment starts on October 15th and ends on December 7th. Any changes you make will become effective on January 1st of 2025. Not only is this a time when people who have Medicare can change their plan, but this is also the time when plans announce their changes for the following year.
For this reason, it is recommended that every year people re-evaluate their Medicare plans for the following year to make sure it is still the best plan for their healthcare and medication needs. The Health Insurance Counseling and Advocacy Program (HICAP), part of the Ventura County Area Agency on Aging (VCAAA), provides free, unbiased counseling on all parts of Medicare. During Open Enrollment, HICAP offers One Stop Shops where you can have an appointment to review your plan, as well as community education presentations. You can learn more at https://www.vcaaa.org/our-services/medicare-help/ or by calling HICAP at 805-477-7300.
I spoke to the HICAP Manager, Sonia Vaughn, about the many changes coming to Medicare in 2025. She shared that “One of the most important things for Medicare recipients to look out for is the Medicare Annual Notice of Changes (ANOC).”
The ANOC is a document that Medicare Part D and Medicare Advantage (Part C) plans are required to send to their members each year. This notice provides a summary of the changes to the plan’s costs, benefits, and rules that will take effect in the upcoming year. This notice is typically mailed to plan members in the fall, usually in September. This gives Medicare beneficiaries the opportunity to review any changes and decide whether to stay with their current plan or switch to one that better suits their needs for the upcoming year.
Vaughn stated “It’s crucial for beneficiaries to carefully review the ANOC to understand how their coverage and costs may change, allowing them to make informed decisions about their healthcare. And of course, clients can contact us to schedule a one-one appointment to go over the Medicare changes and any other changes impacting their plans, such as premium, deductibles, copayments/coinsurance, benefits, network information, and other rules (such as prior authorization or step therapy requirements).”
There are many changes coming to Medicare Plans. One change that may save you money is that there will be a $2,000-a-year out-of-pocket limit for prescription medications. This applies to stand-alone Medicare Part D policies and drug coverage in Medicare Advantage plans.
Medicare is also adding a new program meant to help with payments. The Medicare Prescription Payment Plan provides people the option to pay their out-of-pocket Part D prescription drug costs in monthly amounts over the year, instead of paying when you pick up your prescription. This plan is most beneficial for those who have high prescription drug costs and not on Medi-Cal.
However, with these changes come many others that may change or reduce the benefits you were getting in your plan. In Ventura County there are some plans that will not be offered again in 2025. For this reason, it is extra important to review your ANOC and ensure you select the best plan for your needs in 2025.
It is also important to be careful not to share your Medicare numbers and not to enroll into anything that sounds too good to be true. HICAP is also the local Senior Medicare Patrol entity, and they can help report any fraud and abuse relating to Medicare.
Be vigilant during Open Enrollment this year and every year to make informed decisions for your healthcare needs. Taking some time now could make a significant difference with your coverage in 2025.
Martha Shapiro can be reached at Senior Concerns at 805-497-0189 or by email at mshapiro@seniorconcerns.org.
