Medicare Open Enrollment 2025: What You Need to Know Before December 7th

If you’ve recently turned on your TV or browsed the internet, chances are you've seen an influx of commercials promoting various Medicare plans. That’s because it’s that time of year again — Medicare Open Enrollment, also known as the Annual Enrollment Period (AEP). But beyond the ads, do you really understand what this period means for your health coverage — and your wallet? Let’s break it down and uncover why this time of year could be critical for your healthcare and finances.

The Medicare Annual Enrollment Period runs from October 15th to December 7th each year. During this window, all Medicare beneficiaries — whether on Original Medicare or a Medicare Advantage (Part C) plan — can review and make changes to their coverage for the upcoming year.

Here’s what that means for you:

·         Original Medicare (Parts A & B) users should focus on reviewing their Part D Prescription Drug Plan (PDP).

·         Medicare Advantage enrollees need to review their entire plan, since it includes medical, drug, and often additional benefits bundled together.

If you're enrolled in a Medicare Advantage plan, there's also an extra opportunity — the Medicare Advantage Open Enrollment Period (MAOEP) from January 1st to March 31st, which allows for one plan switch or a return to Original Medicare if needed.

Why You Must Review Your Medicare Plan — Even If You Like It

It’s a common misconception: “If I’m happy with my plan, I don’t need to do anything.” Unfortunately, that’s not true. Medicare plans change every year — and 2026 brings several key updates that could directly impact your coverage and costs.

Here’s what’s changing:

Prescription Drug Costs

·         The annual cap (maximum out-of-pocket limit) on prescription drugs will increase slightly from $2,000 to $2,100.

·         The standard deductible for Part D is increasing to $615.

·         All insulin products should now be capped at $35/month or 25% of the negotiated price — whichever is lower.

Drug Pricing Reforms

·         Thanks to the Inflation Reduction Act, Medicare can now negotiate prices for certain high-cost brand-name drugs. This means you may see lower prices on some commonly prescribed medications.

Vaccines

·         Medicare will now provide free coverage for all CDC-recommended vaccines, including the shingles vaccine.

Premium Increases

·         The average monthly premiums for Medicare Part D plans are projected to increase.

·         The Medicare Part B premium and deductible are also expected to rise, although final amounts have not yet been announced.

Plan Availability

·         The market for Part D and Advantage plans is relatively stable this year, with 12 Part D plans available in 2026 (down slightly from 14 in 2025).

·         This is a far smaller shift than we saw between 2024 and 2025, but still reason enough to compare.

Even if your health hasn't changed, your plan’s coverage, network, or costs likely have. A quick review can help you avoid unexpected costs and access better coverage.

How Reviewing Your Plan Can Save You Thousands

You might be wondering: “How much can I really save?”

The answer: A lot.

Using the Medicare.gov Plan Finder tool, we compare plans based on:

·         Your specific prescriptions

·         Your preferred pharmacy

·         Your healthcare usage

By helping clients switch plans strategically, we collectively saved over $1.3 million — simply by adjusting to changes in drug pricing and pharmacy networks.

And the average plan review? Just 30 minutes. That’s a small time investment for potentially huge savings.

Take Action: Free Medicare Plan Reviews Available Now

If you’re a client of Johnson McGinnis Elder Care Law & Estate Planning, we offer complimentary Medicare reviews to help you navigate the Annual Enrollment Period with confidence. Don’t wait until it’s too late.

Call 615-824-2571 today to schedule your Medicare review and make sure your 2025 coverage will work for you in 2026 — not the other way around.

Final Thoughts

Medicare Open Enrollment is more than a deadline on the calendar — it’s your annual opportunity to protect your health and your finances.

Whether your current plan has served you well or fallen short, the only way to know you’re on the right path is by reviewing your options. And remember: what works for your neighbor, friend, or spouse might not work best for you.

Personalized guidance matters — and we’re here to help.