Michele’s Medicare Monthly October 2025

Medicare Update – October 2025

What’s New in Medicare

Welcome to your October 2025 Medicare Update. This month is crucial for reviewing your Medicare health and drug coverage for next year.

• Open Enrollment runs October 15 – December 7 — use this window to make changes. I have posted my calendar for October and can review your plan at CVS and the other areas I may be attending!

• A new Prescription Payment Plan lets you spread your drug costs over the year.

• Some telehealth coverage expansions may expire unless Congress acts.

• UnitedHealthcare is exiting Medicare Advantage in many counties in 2026 — check if your plan is affected.

• The federal government is in a partial shutdown. Medicare benefits continue, but administrative delays are possible.

Over the next few days, you’ll receive your Annual Notice of Change (ANOC). Please read it carefully, compare plan options with the Medicare Plan Finder, and if needed, reach out for help from a certified Broker like myself!

If you have any questions or want help walking through your options, I’m here to assist!

Prescription drug cost cap & payment flexibility

1. Starting in 2025, Medicare Part D has a maximum out-of-pocket cap of $2,000 for prescription drugs. Once you hit that cap, you will no longer have to pay copays or coinsurance for covered Part D drugs. Also, in January of 2026, This out of pocket cap WILL be increased to $2,100.

There’s also a new option called the Medicare Prescription Payment Plan. This allows those with Part D plans to spread out their out-of-pocket drug costs over the year instead of paying them all at once at the pharmacy.

Updates for Medicare Advantage

1. MA plans are required to send a mid-year reminder about any unused supplemental benefits (like dental, vision, fitness, etc.), so beneficiaries are aware of benefits they might be able to use.

For calendar year 2026, CMS issued final rules impacting MA & Part D that include changes to how prescription drug coverage is handled, how dual-eligible special needs plans (D-SNPs) will be managed, modifications in Star Ratings, and more.

Telehealth services temporarily expanded
The expansion of certain telehealth services (including the ability to use telehealth from home) has been extended through September 30, 2025 under recent legislation. Starting October 1, many of those expanded flexibilities will revert (or be limited) unless renewed.

Rising costs coming in 2026

1. Part B premiums are projected to increase; also the deductible will go up. I belive the new amount will be around $206.00.

Part D premiums & deductibles are expected to rise as well. (see above)

If you are subject to IRMAA (Income-Related Monthly Adjustment Amount), the surcharge (based on higher income levels) will also increase.

Important Dates & What I’m Doing

Open Enrollment (Medicare) is October 15 through December 7, 2025. That’s when you can change your Medicare Advantage plan, Part D plan, or switch between Original Medicare / Advantage.

I am booking appointments now for Open Enrollment in October, and I still have openings. Please check my calendar on the website!

I am also open for November appointments. If you need help comparing plans or making changes, don’t wait—slots fill up.

Other Services I’m Offering

I will be at CVS locations during Open Enrollment. I’ll share a calendar soon with the dates and will be at 44 Gulf Beach Hwy and have posted dates on my site.

I can assist with Special Enrollment Periods for people under65 who use Marketplace (ACA) plans. Note: Open Enrollment for under-65 Marketplace begins November 1st.

While at CVS, I’ll also be able to provide life insurance quotes tailored to fit your budget—feel free to ask when you see me.

What You Should Do Now

When you get your ANOC (Annual Notice of Change), compare it with your current costs and coverage. Don’t assume your plan will work the same way next year.

• Estimate what your drug costs might be under your Part D plan, especially if you take expensive medications. Hitting that $2,000 cap can make a big difference.
• If possible, start thinking ahead about whether you might want to switch plans during the October-December window.
• Mark your calendar for when I’ll be at a CVS near you—and bring your current drug list and medical info so we can get accurate quotes/plan comparisons.
• If you have questions, want me to walk you through your options, or schedule an appointment, just reply to this email / call / message. I’m here to make this as easy and clear as possible for you.

2026 Make sure you do NOT use for Flex card for Utilities or Rent/Mortgage. Medicaid will now be using that amount and counting it as INCOME!!! You could LOSE your medicaid by using the flex card for rent or utilities! Spread the Word.

Warmly,
Michele Wagoner

Your Little Insurance Lady!
Your Medicare Broker