The open enrollment period for Medicare, commonly known as the “Red-Blue Card,” has started for 2025, and significant changes are on the horizon. Insurance experts emphasize that many individuals tend to stick with their current plans rather than actively comparing options and making changes.

David Lipschutz, Co-Director at the Center for Medicare Advocacy, advises people to pay close attention to the changes for next year. “While we repeat this every year, the changes due to the Inflation Reduction Act mean you’ll need to shop around to ensure your medications are still covered under your plan,” he explains.

Lipschutz also points out that those who are engaged and proactive, especially in Medicare Advantage plans or Part D private plans, tend to benefit the most. “However, many people don’t compare at all, or they might just skim their options once and assume they’re done, sticking with their current plan. Inertia often holds people back from doing the necessary research.”

So, how can individuals navigate the upcoming changes to Medicare for next year?

1. **Review the Annual Notice of Change (ANOC)**

This document outlines alterations in Medicare Advantage plans for 2025, including lists of in-network providers and pharmacies, formularies for prescription drugs, and price changes. Individuals can change their coverage during the open enrollment period from October 15 to December 7, while the Medicare Advantage plan enrollment period runs from January 1 to March 31 of the following year.

2. **Examine Drug Coverage and Costs**

The tier levels for medications determine out-of-pocket costs, so it’s vital to check if any current prescriptions have been moved to different tiers in the ANOC. Ensuring that the required medications remain covered and within the correct tier is essential. Lipschutz recommends consulting with an insurance agent to give you ample time to review all medications and identify the most suitable plans, or visiting Medicare.gov to input your current drugs and contact Medicare at 800-MEDICARE for advice on the best options.

3. **Understand Medicare Advantage Plan Changes**

These plans generally offer additional benefits compared to traditional Medicare. It’s crucial to understand which existing benefits will remain in your plan for 2025. Just because a Medicare Advantage plan includes certain benefits does not mean all members will have access to them; often, there are restrictions, such as specific provider networks, whereas traditional Medicare may cover a broader range of doctors. Therefore, it’s important to ask detailed questions to ensure you understand the benefits available to you.

4. **Conduct a Comprehensive Cost Review**

In addition to monthly premiums, factors such as deductibles, copays, and the convenience of accessing services can impact your budget. Consider whether you can accommodate changes to premiums, provider networks, pharmacies, maximum out-of-pocket costs, copays, or coinsurance. Lipschutz advises against solely selecting a plan based on the lowest premium, as opting for the cheapest option often leads to higher overall costs and incomplete drug coverage.