Every year, the Medicare Annual Enrollment Period gives beneficiaries the chance to update or change their healthcare plan or prescription drug plan to suit their needs better.
The Medicare Annual Enrollment Period dates begin on October 15 and end on December 7.
What is Medicare Annual Enrollment Period
During this time, you can add to your plan, drop part of your coverage, or switch to a completely new plan.
Medicare Annual Enrollment Period vs Open Enrollment Period
It’s easy to confuse the two. Medicare Annual Enrollment runs from October 15 to December 7. The Open Enrollment runs from January 1 to March 31.
In light of recent developments, Medicare Annual Enrollment 2024 is a particularly important time to think about updating your Medicare Part D, or prescription drug coverage.
What is Medicare Part D
Medicare health coverage plans are split up into Parts A, B, C (also known as Medicare Advantage), and D.
Anyone having an Original Medicare (Parts A and B) or Medicare Advantage (Part C) plan is given the choice to purchase Medicare Part D prescription drug plan. This helps makes prescription drugs more affordable and is required to satisfy qualified coverage.
For in-depth details on prescription drug coverage, you can check out pages 79-90 of Medicare and You, the official Medicare handbook issued by the US government.
Variations in Part D costs and drug coverage
Part D plans are offered through Medicare-approved insurance providers. You have to pay a monthly premium for your plan, and the premium amount varies according to insurance provider and your individual circumstances such as age and the kind of drugs you need. Other costs (deductibles, copays, coinsurance) vary accordingly.
Coverage may vary as well. It is entirely possible that a Part D plan suitable for you may not suit your partner, even if you are insured by the same insurance provider, because you have different health conditions. Your medications may not be covered by your partner’s Part D plan and vice versa.
What is an Annual Notice of Change (ANOC)
In September every year, persons enrolled in a Medicare Advantage plan will receive an Annual Notice of Change (ANOC) from their insurance provider.
This sample shows what ANOCs usually look like and what kind of information they contain.
The ANOC is different from plan to plan, and defines all the ways in which your plan is updated for the coming year. This includes changes to:
• costs and payments such as premiums, deductibles, copays, etc
• pharmacy and doctor networks
• care supplies, e.g. glucometers and test strips
• allowances for hearing aids and eyeglasses
• monthly credit amounts for over-the-counter drugs and safety/care devices
You should have received your specific ANOC already. If you haven’t, call your plan provider today to request it.
Annual Notice of Change 2025 for Part D prescription drug plans
The ANOC for 2025 is especially important for 2 big reasons.
• Reason 1: Reduced out-of-pocket costs on prescription drugs
Out-of-pocket costs for prescription drugs refer to the money you must pay out of your own pocket before your insurance kicks in. These costs include deductibles, copays, and coinsurance.
For 2025, the US government has reduced out-of-pocket costs and capped the limit to $2,000. This is an annual cap. It means that when you’ve paid $2,000 for your prescription medications, you will not have to pay any more. The cap applies even if you hit $2,000 at the beginning of the year and still have many months of prescription refills left.
• Reason 2: Possible revision of drug formularies
Some healthcare analysts are of the opinion that the lower out-of-pocket expense and the cap may lead healthcare coverage providers to revise their drug formularies, or drug lists. Such revisions could include:
• Moving drugs from one price tier to another
• Adding new drugs to the mix
• Changing quantity limits
• Discontinuing drugs as they are no longer being manufactured
• Substituting brand names with other brands
• Substituting brand names with generic versions
Matching your meds against your plan’s drug formulary
Most providers of Medicare Advantage plans should have released their updated drug formularies by now and these should be available online.
According to a study, 1 out of 3 senior adults takes at least 5 prescription drugs. But whether you take 1 or 5 prescription drugs, here’s an easy way to match your meds against your plan’s drug formulary.
Sit at a table and gather all your medications to your left. One by one, check if they’re listed on your plan’s drug formulary for 2025. If yes, set it to your right. If no, place it in the center of the table.
Put away the meds that have collected on the right side to avoid mix-ups and confusion.
Now repeat the process using different search criteria. All drugs, whether in yellow prescription bottles or manufacturer’s packaging, are labeled with the brand or generic name, as well as active ingredient.
If the brand name you use does not appear on the formulary, search for the generic name or active ingredient.
Should any drugs still remain unmatched, you must discuss this with your doctor at the earliest opportunity. Your doctor should be able to prescribe an alternative drug that is covered by your health plan.
Helpful resources
Should you decide that your current healthcare plan is not quite right for you, you may want to update your coverage.
You can use Medicare’s plan finder tool to explore and compare options.
You can also call experts who can provide guidance and education. Our Patient Relations Team is happy to answer any questions you may have regarding changes to Medicare in 2025. You can speak to a Patient Relations Team member at (800) 941-1106, from 8:00 am to 5:00 pm CST, Monday to Friday.