Medicare open enrollment, runs Oct. 15 through Dec. 7, is an opportunity to review your benefits and make changes for 2025.
Signing up for Medicare or changing plans can seem daunting, but it’s important to make sure you’re enrolled in the best plan for your medical needs.
This guide can help make the process easier. Now updated for 2025, it can help you select the best Medicare plan for you.
If you have any questions about
renewing or applying for Medi-Cal
please contact us at:
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Glossary of terms
1. Premium: The base cost of the health plan, paid monthly. Regardless of whether you choose original Medicare or Medicare Advantage, you will pay the Part B premium monthly. Most people paid $174.70 a month for the Part B premium in 2024.
2. Deductible: The amount of money you spend out-of-pocket before the plan begins paying a larger share of medical expenses. For 2024 the Part B deductible was $240.
3. Copay: A flat fee you pay for certain services, such as a doctor’s visit or prescription medication.
4. Coinsurance: The portion of a medical bill you must pay even after you meet your deductible. Original Medicare has 20% coinsurance after meeting the deductible, which means you will pay 20% of any medical bill.
5. Drug formulary: The list of prescription medications covered by your plan. Formularies rank medications into tiers, with lower-tier drugs being the preferred and least-expensive options. Higher-tier versions of the same medication will cost more. Health plans frequently switch their preferred choices and may even drop medications from the formulary.
6. In-network: Doctors who accept your health plan are in-network. The vast majority of doctors accept original Medicare. Medicare Advantage plan networks vary.
7. Out-of-network: Doctors who do not accept your health plan are out-of-network. You may have to pay more for their services, or the visit may not be covered at all by your plan.
8. Original or traditional Medicare: A federal health program for people who are 65 or older, or who have a qualifying disability. People who choose original Medicare will enroll in Part B, with choices for optional supplemental and drug plans.
9. Medicare Advantage: Medicare plans sold and operated by private insurers. These federally approved plans must cover all Plan B benefits. They can offer extra services, such as coverage for prescription drugs, and may limit the number of in-network doctors.
10. Part A: Covers hospital visits and medications administered in a hospital setting, such as infused drugs. Most people receive Part A coverage when they turn 65 at no additional cost.
11. Part B: Covers doctor’s visits, labs, and other non-hospital services. People who choose original Medicare will enroll in Part B.
12. Part C: Also known as Medicare Advantage.
13. Part D: Prescription drug plans that people who opt for original Medicare can buy.
14. Medigap: Also known as supplemental plans that people who opt for original Medicare can buy to cover out-of-pocket costs, such as copays. Medigap plans do not pay for the Plan B premium.
