Medicare Open Enrollment: What You Need to Know

Medicare open enrollment for 2025 begins October 15 and runs through December 7. This is a good time to look back at your healthcare usage over the last year and think about where you have had high out-of-pocket expenses or gaps in your coverage. If you have, then a change in coverage could help.

Please note these new items for 2025: 

• The prescription drug out-of-pocket maximum is $2,000. This includes deductibles and co-pays. This means you will not pay more than $2,000 for Part D covered medications in 2025. The donut hole and catastrophic phases of Part D coverage have been eliminated.
• Medicare Prescription Payment Plan (M3P) – Starting in 2025, all Medicare prescription drug plans and Medicare Advantage plans with prescription drug coverage must offer enrollees the option of paying out-of-pocket drug costs in capped monthly installments (instead of having to pay all at once). Tip: You can opt-in to M3P, so spread out your out-of-pocket costs for your prescriptions over the course of the year. 

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What can I change during open enrollment?

• Add or change your Medicare Part D (drug) plan
• Change to a different Medicare Advantage plan
• Switch from Original Medicare to a Medicare Advantage plan
• Switch from a Medicare Advantage plan to Original Medicare (compare Original Medicare & Medicare Advantage)
• Purchase or change your Medigap (Medicare Supplemental Insurance) plan 

What can’t I change during open enrollment?

• You cannot add Part B coverage during open enrollment if you didn’t elect it during your initial coverage period. 
  • The general enrollment period for Part B is from January 1 to March 31 every year. Coverage begins the month after you enroll.
  • You may have a late enrollment penalty added to your monthly premiums if you did not elect Part B during your initial enrollment period.
• You cannot purchase a Medigap plan if you have a Medicare Advantage Plan.

Tip: Before you make a change to your coverage, be sure to research any restrictions or limitations that may apply. 

What else should I consider?

• If this is the first time you are electing a Part D plan, you may be subject to Part D late enrollment penalties.
• Prices for Medigap plans may be better during open enrollment. Remember: If you buy a gap plan after your initial coverage period, the insurance company can look at your pre-existing conditions and potentially deny coverage for those conditions for a period of time.
• Eligibility for the Low-Income Subsidy (LIS/Extra Help) was expanded in 2024 and continues in 2025. If eligible, this program can lower your prescription drug costs and pay your Part D premiums. 

Review Medicare plan options for 2025.

Get help navigating open enrollment:

If you have questions or would like assistance as you explore your options, help is available:

1. If there is a financial navigator at your treatment center, they may be able to help you understand your choices and guide you through open enrollment. 
2. The State Health Insurance Assistance Program (SHIP) provides local insurance counseling for Medicare-eligible individuals, their families, and caregivers. SHIP counselors are available nationwide.
3. Our Cancer Support Helpline offers free, personalized navigation by phone and online for people impacted by cancer, including financial navigation. Our financial navigation specialists are trained in cancer-specific issues and resources that may impact your open enrollment decisions. To be connected with one of our financial specialists, call 888-793-9355.