Medicare Open Enrollment

Medicare’s Open Enrollment period is October 15 to December 7. You can review and compare your Medicare options during open enrollment each year. This includes:

• Switching between Original Medicare and Medicare Advantage Plan.
• Changing to another Medicare Advantage Plan.
• Joining or changing Medicare Part D Prescription Drug Plans.

Changes made during the Open Enrollment period, take effect on January 1, 2025.

SOME BASICS: Medicare Part A helps cover inpatient hospital, skilled nursing and hospice care. Part B helps cover doctor’s services, outpatient care, medical supplies and preventive services. The government’s Medicare plan, which you are eligible for beginning at age 65 or for some disabled individuals before 65 (part A & B), is referred to as Original Medicare. People with Original Medicare often sign up separately for Part D (prescription drug coverage) and they may also purchase a separate Medigap insurance plan that helps pay for benefits not covered by Parts A & B. Medicare.gov provides helpful basic information on terms at the following link: Medicare Basics

Medicare Advantage Plans, also called Medicare Part C, offered by private insurance companies provide all the benefits of Parts A and B and may also offer Part D prescription drug coverage as well as other benefits...sometimes at no additional charge beyond Original Medicare.

Plan Annual Notice of Change (ANOC)

Even if you have been satisfied with your current plan, changes can happen every year. Your Medicare plan should have sent you a "Plan Annual Notice of Change" (ANOC) in September, which alerts you to any changes in benefits including coverage, costs, prescription drug plans, out-of-pocket limits and other important details that will take place in January. If you have not received the 2025 ANOC, contact your plan immediately to request it. Carefully review any changes and decide if the plan will continue to meet your needs or not. If you are satisfied with your plan's 2025 coverage, you do not need to take any action, and you will automatically be covered with the same plan -- as long as your Medicare Advantage plan is still available. 

Also review your "Medicare and You" handbook, which you should have received by mid-October. You can also view it online at the following link: Medicare & You

Steps to Take & Questions to Consider:

1. Review all letters and notices from your current plan. 

2. Make a list of all current prescription drugs you take, the doses and how often. Which plans cover your specific medications? You can compare plans at Medicare.gov's Plan Finder at the following link: Plan Finder.

3. Are my doctors, hospitals and specialists in network? Online tools exist to help you find doctors and hospitals in the plan’s network, or you have the option of working with an advisor.

4. Are there new, innovative benefits I should consider? Medicare Advantage plans may cover vision, hearing and dental benefits, as well as additional benefits not covered by Original Medicare such as gym memberships. If you appreciate technology, virtual doctor visits may be included. Some Medicare Advantage plans offer transportation to doctor appointments and other new services.

5. Will a zero-monthly premium (as offered by some Medicare Advantage plans) save me money? Private insurers help keep premiums down through networks, disease and chronic care management and preventive services, but may limit your choices to in-network options.

6. Do I need to sign up for Medicare Parts A and B if I’m still working? If you or your spouse have health insurance from an employer, you can probably delay enrolling in Medicare until the employment coverage stops, although you should still check in with Medicare in advance of turning 65. To keep your employer health insurance, it must be at least as good of coverage as Medicare provides. When your employer coverage ends, you’re entitled to a special enrollment period of up to eight months to sign up without incurring late penalties.

7. For military veterans, how do you know the difference between your VA benefits and Medicare benefits? Medicare and VA healthcare benefits are separate and do not work together. If working with an advisor to help select the Medicare plan that best serves you, let them know if you are eligible for VA health care.

As with any major decision, proper research will go a long way toward making the best plan choice for your personal health care needs. 

Getting Help

Choosing a Medicare plan that is best for you can be a daunting and confusing task. 

You can call 1-800-MEDICARE (1-800-633- 4227) (or TTY: 1-877-486-2048) 24 hours a day, seven days a week.

 SHIBA (Statewide Health Insurance Benefits Advisor) offers free, unbiased help for you to understand your options. Find your local county SHIBA office by calling the Insurance Consumer Hotline at 800-562-6900 or visit https://www.insurance.wa.gov/find-local-shiba-office to find the office located in your county. SHIBA advisors are also available through many local libraries and other institutions. 

Check with your friendly local librarian to see if they are offering SHIBA counseling sessions, or if they can look up other sessions in your area.