Medicare Open Enrollment 2025: What You Need to Know

Medicare Open Enrollment is right around the corner, and it’s one of the most important times of year for anyone enrolled in Medicare. From October 15 through December 7, beneficiaries have the opportunity to review their current coverage and make changes. Updates made during this period will take effect on January 1, 2026.

At Tull Financial Group, we believe that healthcare planning is a vital part of financial wellness in retirement. That’s why we want to ensure our clients are informed, prepared, and protected during this critical window. Whether you’re enrolled in Original Medicare, a Medicare Advantage plan, or a Part D prescription drug plan, this is your annual opportunity to confirm that your coverage still aligns with your health needs and financial goals.

What Can Be Changed During Open Enrollment?

During this period, Medicare beneficiaries can:

• Switch from Original Medicare to a Medicare Advantage plan or vice versa. 
• Change from one Medicare Advantage plan to another.
• Add or change a Medicare Part D prescription drug plan to better match current prescriptions and pharmacy preferences.

Even if you’re satisfied with your current plan, it’s wise to review it. Plans can, and often do, change each year. Premiums, deductibles, drug formularies, and provider networks may be updated, which could impact your costs or access to care. A quick review now can prevent costly surprises later.

What’s New for 2025?

One of the most significant updates this year is the implementation of a $2,000 out-of-pocket cap on covered prescription drugs under Medicare Part D. This change is designed to help protect beneficiaries from excessive drug costs and is part of a broader effort to make healthcare more affordable for retirees.

However, it’s important to note that this cap only applies to medications covered by your plan’s formulary. If your prescriptions aren’t included, you may still face high out-of-pocket expenses. This makes it especially important to review your drug coverage carefully. We recommend making a list of your current medications and using the Medicare Plan Finder tool at Medicare.gov to compare how different plans cover them.

Tips for a Successful Enrollment

To help you navigate this process smoothly, here are a few key steps to consider:

1. Review Your Annual Notice of Change (ANOC): You should have received this notice in late September. If you have not received yours, reach out to your plan provider. This document outlines any changes to your current plan for the upcoming year. Pay close attention to premiums, copays, deductibles, and provider networks.
2. Evaluate Your Health Needs: Have your health needs changed in the past year? Are you seeing new specialists or taking new medications? Make sure your plan still supports your current situation and expected needs in the coming year.
3. Compare Plans Thoughtfully: Don’t focus solely on monthly premiums. Consider the total cost of care, including deductibles, copays, and out-of-pocket maximums. Also check whether your preferred doctors and hospitals are in-network.
4. Watch for Hidden Costs: Some plans may look attractive on the surface but have limited provider networks or high costs for specific services. Be sure to read the fine print.
5. Ask for Help: Medicare is complex, and it’s okay to ask questions. Our team is here to support you.

Download: 3 Ways to Prepare for Medicare Enrollment

Be Cautious: Scams and Misleading Marketing Are on the Rise

Unfortunately, Medicare Open Enrollment also brings an increase in unsolicited phone calls, mailers, and advertisements; some of which are misleading or even fraudulent. Here’s what to watch out for:

• Unsolicited Calls Claiming to Be Medicare: Medicare will never call you to sell plans. If someone claims to be from Medicare and asks for personal information, hang up immediately.
• High-Pressure Sales Tactics: Be cautious of anyone urging you to “act now” or claiming that a plan is only available for a limited time. You have until December 7 to make changes, don’t rush!
• Misleading Promises: Some ads highlight low premiums but hide high deductibles or limited provider networks. Always verify the full details before switching.
• Requests for Personal Information: Never give out your Medicare number, Social Security number, or banking information to unknown callers or websites.

If you receive a call or see an ad that seems suspicious, we encourage you to reach out to our office before making any changes. We’re here to help you verify whether it’s legitimate and whether the plan is a good fit for your needs.

Meet Our Medicare Specialist

We’re proud to have Amy Pucci, Certified Senior Advisor (CSA)®, as our in-house Medicare specialist. Amy has over 15 years of experience working with retirees and is deeply knowledgeable about Medicare, Social Security, and aging transitions. She regularly consults with clients to help them navigate the complexities of Medicare and make confident, informed decisions.

Amy is available to assist you with:

• Reviewing your current Medicare coverage,
• Comparing Medicare Supplemental, Advantage and Part D plans,
• Understanding how changes in your health or medications may affect your coverage, and
• Avoiding common enrollment mistakes and scams.

Her guidance can help you avoid costly errors and ensure your healthcare coverage supports your retirement goals.

We’re Here to Help

At Tull Financial Group we believe financial planning doesn’t stop at investments, but includes healthcare, lifestyle, and long-term well-being. Medicare is a key part of that picture, and we’re committed to helping you make the most of it.

If you’d like to schedule a Medicare review with Amy or have questions about your financial plan, please reach out to us. We’re here to support you every step of the way.

Frequently Asked Questions (FAQs)

Who is eligible to make changes during Medicare Open Enrollment 2025?

Anyone who is already enrolled in Medicare, whether through Original Medicare or a Medicare Advantage plan, is eligible to make changes during the annual open enrollment period which runs from October 15 to December 7, 2025.

What changes can I make during the Medicare Open Enrollment period?

During open enrollment, you can:

• Switch from Original Medicare to a Medicare Advantage Plan.
• Switch from Medicare Advantage back to Original Medicare.
• Change from one Medicare Advantage Plan to another.
• Join, drop, or switch a Medicare Part D prescription drug plan. 
• Add or drop drug coverage from a Medicare Advantage Plan.

All changes take effect on January 1, 2026. 

Can I switch from Original Medicare to a Medicare Advantage Plan in 2025?

Yes. You can switch from Original Medicare to a Medicare Advantage Plan during the Open Enrollment period (Oct 15–Dec 7). Most Medicare Advantage plans state that they include additional benefits like dental, vision, and prescription drug coverage; however, it is not always easy to find a provider who offers dental and/or vision to those with Medicare.  

It is important to note that if you find that you wish to change back to Original Medicare you may have to go through underwriting and be denied.

Can I change my Medicare Part D prescription plan during Open Enrollment 2025?

Yes. You can join, drop, or switch your Medicare Part D plan during Open Enrollment. This is a good time to review your current plan’s formulary and costs to ensure your medications are still covered affordably.

What happens if I miss the Medicare Open Enrollment deadline?

If you miss the December 7 deadline:

• You’ll typically stay enrolled in your current plan for next year. 
• You cannot make changes unless you qualify for a Special Enrollment Period (SEP) due to events like moving, losing other coverage, or plan termination.