Annual Election Period for 2025

The Medicare Annual Election Period (AEP) is a critical time for anyone currently enrolled in Medicare. It runs from October 15th to December 7th each year and provides Medicare beneficiaries with the opportunity to review and make changes to their Medicare coverage. Making informed decisions during this period can ensure that you have the best possible coverage for your healthcare needs in the coming year. 

Why is the Annual Election Period Important?

Health and financial needs can change over time, and so do Medicare plans. Insurance providers often adjust their Medicare Advantage (Part C) and Medicare Prescription Drug Plans (Part D) offerings, which can impact your out-of-pocket costs, drug coverage and access to healthcare providers. The AEP is your chance to reassess  your current plan and make changes to better suit your needs for the upcoming year.
Ignoring the AEP could lead to being locked into a plan that no longer meets your needs or paying more than necessary for your healthcare. By actively reviewing your options during this period, you can potentially save money, enhance your coverage, or ensure your preferred doctors and pharmacies remain in-network.

What Can Be Changed During the Annual Election Period?

During the Medicare Annual Election Period, you can make several important changes to your coverage.

1. Make changes to your Part D prescription plan: You can switch to a different Part D plan, or join a plan for the first time. You can also drop you Part D plan during this period. Changes made during the Annual Election Period  will take effect on January 1st of the following year.
2. Switch from a Medicare Advantage Plan to Original Medicare: If you're unhappy with your Medicare Advantage Plan or find that Original Medicare better suits your needs, you can revert to Original Medicare during this period. You can also add a stand-alone Medicare Part D plan if you return to Original Medicare.
3. Change from one Medicare Advantage Plan to Another: You can switch to a different Medicare Advantage Plan if you find one that offers better benefits, a lower premium, or a network that better meets your needs.
4. Leave Original Medicare and join a Medicare Advantage Plan: If you currently have Original Medicare and are looking for additional benefits such as vision, dental, and hearing, this is you chance to make the change to an Advantage Plan. 
5. Medicare Supplements can be changed, but no special rules apply, they still need to go through Medical Underwriting.

Reasons to Change Your Current Plan to a New Plan?

This time of year may feel overwhelming if you are unsure if you should stay with your current plan or if you should make a change. Here are some key reasons why you might consider making plan changes during the Annual Election Period.

1. Changes in Health Needs: As your health changes over time, so do your healthcare needs. You may find that your current Medicare plan no longer provides adequate coverage for your medications, treatments, or services. For instance, if you've been diagnosed with a new medical condition or if your prescription drug needs have increased, switching to a plan with better coverage for your specific needs can help manage costs and improve your access to care.
2. Plan Cost Adjustments: Medicare plans often adjust their premiums, deductibles, copayments, and coinsurance amounts each year. If you notice that your current plan's costs have increased or if you find a more affordable plan that offers similar or better coverage, it may be worth making a switch. The AEP allows you to compare the costs of different plans and select on that fits your budget.
3. Changes in Plan Benefits: Plan benefits can also change from year to year. For example, a Medicare Advantage plan may add or drop benefits such as dental, vision, hearing or wellness programs. If your current plan is no longer offering the benefits that are important to you, or if you discover a new plan that offers better perks, the AEP is the time to make a change.
4. Provider Network Changes: Medicare Advantage and some Part D plans have specific networks of doctors, hospitals, and pharmacies. These networks can change annually, potentially affecting your ability to see preferred healthcare providers or access certain services. If your doctor or healthcare facility is no longer in your plan's network, or if you've moved to a new area with different network providers, switching plans might be necessary to maintain continuity of care.
5. Dissatisfaction with Current Plan: Sometimes, beneficiaries are simply dissatisfied with their current plan's performance, customer service, or coverage. Whether you've experienced issues with claim denials, slow reimbursements, or poor customer support, the AEP gives you the chance to find a plan that better aligns with your expectations and service standards.
6.  New Plan Options: Each year, new Medicare plans may become available, offering better coverage, lower costs, or more appealing benefits than your current plan. Exploring these new options during the AEP can help you discover a plan that better suits your healthcare needs and lifestyle.
7. Prescription Drug Coverage (Part D) Changes: If you have a standalone Part D plan or a Medicare Advantage plan that includes drug coverage, it's important to review the formulary (list of covered drugs) each year. Plans may add or remove drugs, change their pricing tiers, or adjust the rules for accessing certain medications.

Conclusion

The Annual Election Period is a valuable opportunity to reassess your Medicare coverage and make changes that better align with your health needs, financial situation, and personal finances. Taking the time to compare plans, review changes, and consider your options can help you secure the best possible coverage for the coming year. Having a trusted agent who will walk with you every step of the way can take a lot of the pressure and confusion out of your decisions. Please contact us!
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To Get Help Now, Call Our Office

​Rob Davies
Prairie Grove Insurance
800-254-5200
​608-839-0275