Medicare Open Enrollment: What You Need to Know for the 2025 Coverage Year
Key takeaways:
Medicare open enrollment for the 2025 coverage year begins October 15 and ends December 7, 2024.
You will need to choose either original Medicare (Parts A and B) or a Medicare Advantage plan (Part C). Part C is a private alternative to original Medicare that typically includes prescription coverage (Part D). You can buy a stand-alone Part D plan if you choose original Medicare or if your Medicare Advantage plan doesn’t cover prescription medications.
Medicare supplement insurance (Medigap) helps cover out-of-pocket costs for original Medicare enrollees. Medigap is an additional plan with its own premium.
Table of contents
Autumn is the season for Medicare open enrollment. This is the time when older adults and others who qualify for Medicare choose health coverage for the next calendar year.
Medicare open enrollment begins October 15 and ends December 7, 2024. The coverage you select during this period will start on January 1, 2025.
If you are becoming eligible for Medicare by turning 65 soon, you can start your research now so you’ll be informed when it’s time to join Medicare. Sign up as early as possible to ensure you’re enrolled within your 7-month initial window. If you’re new to Medicare, view this quick comparison of original Medicare and Medicare Advantage (MA) plans. If you already have Medicare, this Medicare plan finder tool can help you explore MA plans, Part D prescription plans, and Medigap supplement plans.
Save over 40% on Qsymia with GoodRx
Discover the once daily Qsymia for weight management. Qsymia is for adults and children 12-17 in combination with a healthy diet and regular exercise.
Our Medicare guide explains eligibility rules, costs, and coverage for original Medicare and MA plans.
Even if you’re happy with your coverage, check your plan before open enrollment ends. Costs and benefits often change, and you could be missing out on perks and savings. For people with original Medicare, the open enrollment period in the fall is the only guaranteed chance to switch plans each year.
Next, we’ll discuss what’s new for Medicare plans in 2025 and what to do if you’re enrolling for the first time. There’s also information for people signing up for a Part D prescription plan for the first time.
What’s open enrollment? And what can you change?
Fall open enrollment offers the most flexibility for switching Medicare plans. Beneficiaries with original Medicare can:
Switch to an MA plan.
Stay with original Medicare and join a Part D prescription plan.
Stay with original Medicare and switch their Part D plan.
Drop Medicare prescription coverage.
During fall open enrollment, those with MA can also make changes. These enrollees can:
Change from an MA plan to original Medicare.
Switch from one MA plan to another.
Switch from an MA plan without Part D coverage to one with prescription coverage.
Switch from an MA plan with prescription coverage to one without prescription coverage.
Get ready for Medicare open enrollment: Assessing your healthcare needs, prescription medications, and financial situation are ways to prepare for the annual Medicare open enrollment period.
Donut hole disappears: The new Medicare Part D $2,000 out-of-pocket limit begins in 2025, and the coverage gap known as the “donut hole” ends on December 31, 2024.
Medicare prescription payment plans: As of January 1, 2025, anyone with a Medicare prescription plan will have the option to make payments for medication costs instead of paying up front at the pharmacy.
If you have MA, there is another open enrollment period from January 1 to March 31, 2025, to make certain changes. (We’ll discuss more about the MA open enrollment period later.)
If you need help, consider these helpful tools and resources:
Medicare & You 2025 handbook
Read more like this
Explore these related articles, suggested for readers like you.
What’s new this year for Medicare open enrollment?
Medicare in 2025 has some higher costs and some lower costs.
The standard monthly Part B premium will be $185 in 2025. This is $10.30 more than in 2024. The annual deductible for Part B is also higher: $257 in 2025, which is $17 more than in 2024.
Medicare Part D plans in 2025 will have higher deductibles but a much lower out-of-pocket threshold. The average projected Part D premium is $46.50 a month in 2025, which is $8.35 lower than in 2024.
Medicare Part D changes
Part D will have three major updates in 2025:
$2,000 out-of-pocket limit: You won’t pay more than $2,000 out of pocket for covered medications. When you reach that spending cap, your Part D prescription plan pays 100% of the costs of your covered medications.
Donut hole eliminated: Part D plans will no longer have a donut hole, or coverage gap. After you meet your deductible, which can’t exceed $590, you’ll pay copays and coinsurance for covered medications until you reach the $2,000 out-of-pocket limit.
Medicare Prescription Payment Plan: Starting in 2025, anyone with a Medicare prescription plan will have the option to make payments for their out-of-pocket medication costs instead of paying up front at the pharmacy. With the new Medicare Prescription Payment Plan, your covered medication costs will be spread out across the year.
Medicare Part D plan redesign
When the donut hole sunsets, the Medicare Part D plan design will have three phases:
Deductible phase: During this phase, enrollees pay all of their prescription medication costs until they meet the Part D deductible, which is $590 in 2025 for most enrollees. (Some plans have a lower deductible or no deductible.)
Initial coverage phase: Enrollees pay copays and coinsurance for covered prescriptions until reaching the out-of-pocket limit. This cap is $2,000 in 2025 and will be adjusted annually based on inflation. Only what enrollees pay for covered medication will count toward the out-of-pocket limit. Manufacturer discounts on covered medications will no longer be calculated into your out-of-pocket spending.
Catastrophic coverage phase: Enrollees have spent $2,000 on covered prescriptions. There is no more cost sharing for covered Part D medications for the rest of the year.
Where do I start?
If you have MA and/or a Part D plan, start by reviewing your Annual Notice of Change (ANOC). MA and stand-alone Part D plans must send beneficiaries this document by September 30 every year. The ANOC can help you compare your premiums, copays, and coverage with the new ones for 2025.
Pay attention to the formulary (the list of covered medications) and changes to your plan’s network of pharmacies.
Before you make a change, make sure your new plan covers your medications and that you can access them at an affordable cost.
Also consider coverage restrictions such as prior authorization, step therapy, and quantity limits. They can make getting covered medications more difficult.
What if I want to enroll in Medicare for the first time?
Medicare covers people age 65 and older, plus some younger people with disabilities and those with permanent kidney failure requiring a transplant or dialysis.
Most people qualify for Medicare at age 65. You’ll have a 7-month enrollment window that begins when you’re age 64. This includes the 3 months before your birth month, your birth month, and 3 months after your birth month. If you or your spouse has worked and paid Social Security taxes for 10 years, your Medicare coverage includes Part A (hospital insurance) at no cost. Medicare Part B (medical insurance) has a monthly premium.
People who have paid Social Security taxes for less than 10 years pay Part A premiums, and people who didn’t contribute pay a higher rate. For 2025, the standard Medicare Part B premium is $185. But it could be higher depending on your income.
Prescription coverage isn’t included in original Medicare. You can buy a Part D plan separately, unless you have creditable coverage for prescriptions from another source. (Examples of creditable insurance include employer-based coverage or a retiree prescription plan that is as good as Part D). If you have an MA plan, prescription coverage is often included.
You’ll want to sign up for prescription coverage when you initially join to avoid the Part D enrollment penalty, which we will discuss later. If your income is low, check to see if you’re eligible for the Extra Help subsidy to assist with Part D premiums and other out-of-pocket costs.
What is Medicare Advantage?
MA plans (Part C) are offered by private companies. You’ll still get Medicare Parts A and B, and the plans often throw in extra benefits such as vision care, dental care, and gym membership. Most — but not all — MA plans include prescription drug coverage.
You should choose carefully because MA provider networks are typically limited to your local area. Make sure your plan covers your primary care physician and any specialists you see. You’ll also want to make sure the formulary includes the prescriptions you take.
MA plans can be attractive, but they may not be the best option for you. You can call a counselor at SHIP to get help understanding the fine print. SHIP provides free, unbiased advice.
How can I avoid the Part D late enrollment penalty?
There’s a financial penalty for signing up late for Medicare prescription coverage. If you don’t have other creditable coverage, the costs can add up fast.
The penalty is calculated on an annual base amount — $36.78 in 2025 — and increases your premium 1% for each month you didn’t have Part D or creditable coverage. That penalty amount is added to your monthly Part D premium. For instance, a person who is 2 years late, or 24 months, would have a 24% upcharge or about $8.80 added to their Part D monthly premium in 2025.
The penalty exists to encourage Medicare beneficiaries to enroll in prescription coverage when they’re first eligible and not wait until they’re older, when they may take more medications. This allows Medicare to balance costs among enrollees.
Even if you don’t take medications now, you should sign up for Part D because the penalty compounds. It isn’t a one-time late fee.
What is Medigap, and do I need to enroll in that too?
Medigap is another name for Medicare supplement insurance. This plan helps pay for out-of-pocket costs such as copays and deductibles — but only if you have original Medicare. Private companies sell Medigap plans that carry letter names. Every plan with the same letter has the same benefits, so the only factor to compare in each category is the premium.
States and the federal government standardize 10 Medigap plans: A, B, C, D, F, G, K, L, M, and N. But not all of them may be available in your state. Plan F and Plan G also have high-deductible options in some states. Some plans cover foreign travel emergencies and stays at skilled nursing facilities, among other expenses.
Medicare offers a Medigap policy search tool. Here are tips for choosing a Medigap plan. And there are steps to follow when you’re ready to make your choice.
Medigap policies are available at the lowest cost during your one-time, 6-month Medigap open enrollment period. This starts when you’re age 65 and enrolled in Part B coverage. If you wait, you could face medical underwriting. This may result in the Medigap plan charging you more or denying you coverage.
Some people may have all the coverage they need for extra medical expenses and that insurance can be coordinated with Medicare. Those situations include:
Union coverage
Military or veterans coverage, such as Tricare
Employer-based plans, which can be coordinated with Medicare
The bottom line
Medicare open enrollment for the 2025 coverage year is October 15 to December 7, 2024. During these 7 weeks, you can join, switch, add, or drop coverage. In 2025, Part B premiums will be higher than in 2024, but the average projected Part D premium will be lower.
Managing Part D costs will be easier in 2025. That’s because prescription plans now have a $2,000 out-of-pocket cap. After that, your plan pays 100% of the cost of covered medications. You can also spread out your prescription costs over the year instead of paying up front at the pharmacy. This flexibility comes from the new Medicare Prescription Payment Plan.
Why trust our experts?
References
Assistant Secretary for Planning and Evaluation. (2024). —Inflation reduction act research series— Medicare Part D enrollee out-of-pocket spending: Recent trends and projected impacts of the inflation reduction act. U.S. Department of Health and Human Services.
Centers for Medicare & Medicaid Services. (2024). 2025 Medicare Parts A & B premiums and deductibles.
Centers for Medicare & Medicaid Services. (2024). Medicare Advantage and Medicare prescription drug programs to remain stable as CMS implements improvements to the programs in 2025.
Medicare.gov. (n.d.). Avoid late enrollment penalties. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Compare Medigap plan benefits. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Compare original Medicare and Medicare Advantage. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Contact Medicare. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Drug coverage (Part D). Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). End-Stage Renal Disease (ESRD). Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Explore your Medicare coverage options. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Find a Medigap policy that works for you. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Get ready to buy. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Get started with Medicare. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Help with drug costs. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). How do I buy a Medigap policy? Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). How Medicare works with other insurance. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Joining a plan. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Learn what Medigap covers. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Part D late enrollment penalty. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Retiree insurance & Medicare. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). What’s Medicare supplement insurance (Medigap)? Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). What’s the Medicare prescription payment plan? Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). When does Medicare coverage start? Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Yearly deductible for drug plans. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Your coverage options. Centers for Medicare & Medicaid Services.
Medicare.gov. (n.d.). Your health plan options. Centers for Medicare & Medicaid Services.
Medicare.gov. (2024). Medicare and you 2025. Centers for Medicare & Medicaid Services.
Medicare Interactive. (n.d.). Creditable drug coverage.
Medicare Interactive. (2024). 2024 guide to Medicare open enrollment.
Tricare. (2023). Beneficiaries eligible for Tricare and Medicare.
