Medicare open enrollment 2025: Medicare open enrollment is currently underway, giving more than 66 million Americans a chance to review and make changes to their health coverage before the deadline, as per a report. The enrollment period runs from October 15 to December 7, and any changes made during this time will take effect on January 1, as per a Yahoo Finance report.

What You Can Change During Medicare Open Enrollment

This period is the only opportunity most Medicare participants have to change their plans unless they qualify for a special enrollment period, as per the report. Reviewing coverage now helps ensure their plan still meets their needs for the coming year, as per the Yahoo Finance report.

During open enrollment, participants can:

• Switch from traditional Medicare to a Medicare Advantage plan, or the other way around, as per the Yahoo Finance report.
• Enroll in a Medicare Part D plan if they have traditional Medicare, as per the report.
• Move from one Part D plan to another
• Select a different Medicare Advantage plan available in their area

Beneficiaries are encouraged to go through the materials they receive regarding plan updates. These are usually titled “Evidence of Coverage” (EOC) or “Annual Notice of Change” (ANOC) and include details about eligibility, premiums, and plan adjustments, as per the Yahoo Finance report.

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Traditional Medicare Coverage Explained

Traditional Medicare, also known as original Medicare, includes Part A for hospital stays and Part B for doctor visits, as per the report. Most doctors across the country accept patients with traditional Medicare. While many beneficiaries do not pay premiums for Part A, there are monthly premiums for Part B, along with deductibles, co-pays, and co-insurance, as per the Yahoo Finance report. Prescription coverage under traditional Medicare is offered separately through Part D, which also has its own premiums, as per the report.

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Medicare Advantage Plans: Benefits and Limitations

Medicare Advantage plans, provided by private insurers, bundle several parts of Medicare into one plan. These plans often have low premiums and yearly out-of-pocket caps, as per the Yahoo Finance report. Some include dental or vision coverage and may combine Part D prescription coverage as well. However, they may limit which healthcare providers can be seen and might require pre-approvals for certain procedures, as per the Yahoo Finance report.

The Medicare Advantage open enrollment period is separate, running from January 1 to March 31 each year. This period is only for those already enrolled in a Medicare Advantage plan who wish to make adjustments, as per the Yahoo Finance report.

What’s Changing in 2026

In 2026, out-of-pocket costs for prescriptions under Medicare’s Part D plan will be capped at $2,100, an increase from $2,000 in 2025, as per the report. The maximum deductible for Part D will rise from $590 in 2025 to $615 in 2026, as per the Yahoo Finance report.

The Four Parts of Medicare Explained

Medicare coverage is divided into four main parts, as per the Yahoo Finance report:

• Part A: Covers inpatient, hospice, and home healthcare.
• Part B: Covers medically necessary and preventive services, including doctor visits, medical equipment, ambulance services, and some mental health care, as per the Yahoo Finance report.
• Part C: Known as Medicare Advantage, it combines Part A, Part B, and usually Part D into one plan.
• Part D: Covers prescription drugs, including vaccines and shots, as per the report.

What Medicare Doesn’t Cover

Standard Medicare does not cover services such as, as per the Yahoo Finance report:

• Eye exams and prescription eyewear
• Cosmetic surgery
• Massage or chiropractic therapy
• Hearing aids
• Concierge medicine
• Dental care

While routine physical exams are not covered, Medicare does pay for an annual “wellness” visit that includes screenings, prescription updates, and cognitive assessments, as per the Yahoo Finance report.

FAQs

When does Medicare open enrollment take place?
It runs from October 15 to December 7 each year, with any changes taking effect on January 1, as per the Yahoo Finance report.

What is new in Medicare coverage?
The Part D prescription cap will rise to $2,100, and the maximum deductible will increase to $615, as per the Yahoo Finance report.