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The Alliance for Rights and Recovery

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Resources for Advocates: Medicare Open Enrollment and New Special Enrollment Periods in 2025

by The Alliance for Rights and Recovery


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.听 started October 15 and ends December 7 (with coverage changes taking effect January 1, 2025).听
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, 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 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 , also known as 鈥淓xtra Help,鈥 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 or enroll in Medicare Advantage.
Resources for Advocates:
* Justice in Aging:
* NCLER Training: Legal Basics: Medicare Parts A, B, and C ( & )
* NCLER Chapter Summary:
* NCLER Practice Tip:
*Justice in Aging: (includes outreach materials)
NCLER Website Visit our , which features听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.


Request a Free Case Consultation Case consultation assistance is available for attorneys and professionals seeking more information to help older adults.听Contact NCLER at . 听