Resources for Advocates: Medicare Open Enrollment and New Special Enrollment Periods in 2025 Fall is time for Medicare enrollees to review and select their 2025 coverage. Medicare open enrollment started October 15 and ends December 7 (with coverage changes taking effect January 1, 2025). Open Enrollment Periods (OEPs) are certain times of the year when individuals can change their health care coverage. There are many changes happening in 2025 that advocates working with older adults should know about when counseling their clients during open enrollment this year. * Changes to Some Special Enrollment Periods: Starting in 2025, two changes are happening to Special Enrollment Periods for low-income Medicare enrollees who wish to join, change, or drop Medicare Advantage coverage. Two new Special Enrollment Periods (SEPs) will be starting in January 2025 replacing the Quarterly Special Enrollment period previously available to dually eligible individuals and Low-Income Subsidy enrollees. The new SEPs will impact when people can make changes to their Medicare Advantage coverage. Some people may have to wait until next open enrollment or qualify for another Special Enrollment Period to change their Medicare Advantage enrollment in 2025. * Changes to Part D Costs: The Inflation Reduction Act included a number of provisions that decrease the out-of-pocket costs for Medicare Part D prescription drugs. One provision, beginning in January 2025, will limit annual out-of-pocket prescription costs to $2,000. Also starting in January 2025, Medicare enrollees will have the option to spread their out-of-pocket costs throughout the year via Medicare Prescription Payment Plans. * Loss of Low-Income Subsidy Eligibility: With many people losing Medicaid during the past year, they may have received a notice in September that they need to affirmatively apply for the Low-Income Subsidy, also known as “Extra Help,” to retain access to their financial assistance for prescription drug out-of-pocket costs. If people are not eligible for the subsidy, they may want to choose a lower cost prescription drug plan or enroll in Medicare Advantage. Resources for Advocates: * Justice in Aging: Important Changes in 2025 to Special Enrollment Periods for Low-Income Medicare Enrollees * NCLER Training: Legal Basics: Medicare Parts A, B, and C (Recording & Issue Brief) * NCLER Chapter Summary: Medicare Savings Programs * NCLER Practice Tip: Your Low-Income Clients May be Overpaying for Part D Prescription Drug Coverage *Justice in Aging:Important Update: Medicare Enrollees Could Lose Financial Assistance for Drug Costs if They Do Not Act Centers for Medicare and Medicaid Services:Medicare Open Enrollment (includes outreach materials) NCLER Website Visit our website, which features tools to help you access the information you need to serve older adults in your community. We are in the process of updating our website, so stay tuned for new materials. Was this forwarded to you? Subscribe here Request a Free Case Consultation Case consultation assistance is available for attorneys and professionals seeking more information to help older adults. Contact NCLER at ConsultNCLER@acl.hhs.gov. View as webpage |