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October 13, 2025 Health/Employee Benefits News
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October is critical month for people on Medicare

Southeast Iowa Union

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Southeast Iowa Union offers audio versions of articles using Instaread. Some words may be mispronounced.

October is a critical month for those on Medicare. With the start of the Annual Open Enrollment Period Oct. 15, those on Medicare have until Dec. 7 to join, switch or drop a Medicare Advantage (Part C) or Part D (prescription drug) plan.

Costs, benefits, provider networks and what prescriptions a plan covers in a Medicare Prescription Drug Plan or a Medicare Advantage Plan can change each year. Comparing and evaluating options can help people find the best coverage and possibly save money.

Despite these annual changes only 3 in 10 Medicare beneficiaries compare plans, according to Kaiser Family Foundation.

It's important to be proactive about Medicare cover. Here are some ways to accomplish that.

1. Read all mail from your plan or medical providers to ensure that you are informed of any changes. Medicare beneficiaries receive an Annual Notice of Change each September from their Prescription Drug Plan or Medicare Advantage Plan. This is a summary of changes to the plan, such as premium cost, coverage, co-pays and service area, that will take effect Jan. 1 of the following year.

Some beneficiaries will also receive notice that their plan may not continue, and they will need to find a new plan during the Open Enrollment Period.

If you are in a Medicare Advantage plan. you may also receive updates from your medical providers about whether they will remain in your plan's network.

2. Compare plan options. Start by gathering the following information: your Medicare number (from your Medicare card); a list of all your current prescription drugs, including the dosage and frequency; the name and address of your preferred pharmacies; the names and addresses of your doctors, including specialists, and your hospitals if you are comparing Medicare Advantage Plans.

Once you have your information there are options available for comparing plans.

You can compare options in your ZIP code in 2026 through Medicare.gov Plan Finder (gov/plan-compare). Plan Finder even allows you to add your specific prescriptions and pharmacies. The Iowa Insurance Division through its Senior Health Insurance Information Program provides tools for using the Medicare Plan Finder at shiip.iowa.gov/medicare-open-enrollment-period.

The Senior Health Insurance Information Program also provides free, confidential and unbiased one-on-one Medicare counseling with the support of federal funding. Iowans seeking assistance on completing plan comparisons have access to SHIIP-SMP counselors across the state. Counselors can be found by visiting shiip.iowa.gov/find-resources/find-counselor and entering your county, or by calling our consumer line at line at 1-800-351-4664.

Help from Medicare is available 24 hours a day, seven days a week, except some federal holidays, at 1-800-MEDICARE (1-800-633-4227). TTY users can call 1-877-486-2048.

3. Make a coverage decision. Reviewing plans ensures you understand key factors that impact your coverage decision, such as premium costs, provider networks (if comparing Medicare Advantage Plans) and which of your prescription drugs are covered.

Enrollment in a new plan can be done at Medicare.gov/plan-compare, with a SHIIP/SMP Counselor or with Medicare directly at 1-800-MEDICARE (1-800-633-4227). Enrollments completed between Oct. 15 and Dec. 7 are for plants that start Jan. 1.

If, after comparing plans, you are happy with your current coverage, no action is necessary during Open Enrollment. You will automatically be re-enrolled for the following year.

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