If you’re enrolled in Medicare, it’s important to remember Medicare Open Enrollment is open through Dec. 7. This is the time to compare prescription drug and health coverage options for the upcoming year.
It is important to compare your options because plans can change every year – even your current choice may be changing. Your health needs can change, too. By reviewing and comparing coverage, people can see if there are better options based on changes to their current plan, personal budget and health needs.
New This Year
The new prescription drug law is lowering out-of-pocket costs on covered prescriptions. All 2025 Medicare plans will include a $2,000 annual cap on what you pay out-of-pocket for prescription drugs. The cap only applies to drugs that are covered by your plan, so it’s more important than ever to review your plan options to make sure your drugs are covered.
Also starting in 2025, you can choose to spread your out-of-pocket drug costs across the calendar year instead of paying all at once. It’s called the Medicare Prescription Payment Plan. All plans offer this payment option, and participation is voluntary. Contact your plan for more information.
How to Compare Prescription Drug and Health Coverage Options
Medicare.gov is the official source for information about Medicare and Open Enrollment. Get started by clicking on “Find Plans Now.” Then enter your ZIP code, current prescriptions and favorite pharmacies. You will see a side-by-side comparison of the total cost for all the plans in your area, including the premium and how much you’ll pay for your prescriptions. You’ll also be able to see what plans cover your prescriptions and whether some plans offer extra benefits. If you are happy with your current choice, you don’t have to do anything. If you choose a new option for 2025, you can enroll on Medicare.gov.
Before you enroll in a plan, consider this advice:
- Check if your health care providers are in a plan’s network.
- Check if your prescriptions are included on a plan’s formulary and if the plan works with your pharmacy.
- Review a plan’s estimated total costs to you, including deductible and other out-of-pocket costs. Remember low monthly premiums may not always be the best overall value for your specific needs.
- Check if Medicare Advantage plans offer extra benefits, like vision, hearing or dental coverage, if you need these services.
Plans change every year – compare your options today at Medicare.gov
Medicare Can Help
To compare options and find the best coverage to fit your needs:
- Visit Medicare.gov.
- Call 1-800-MEDICARE. Help is available 24 hours a day, including weekends.
- Access free health insurance counseling, from your State Health Insurance Assistance Program (SHIP). Visit shiphelp.org or call 1-800-MEDICARE.
Extra Help with Prescription Drug Costs
If you are struggling with prescription drug costs, Extra Help is a Medicare program that can help pay for your drug coverage premiums, deductibles, and other costs. If you make less than $23,000 a year ($31,000 for married couples), it’s typically worth it to apply. Visit ssa.gov/ExtraHelp.
