Medicare Open Enrollment is Coming
- Staff
- 6 days ago
- 3 min read
Medicare Open Enrollment begins October 15 and runs through December 7 each year. This is your chance to review, compare, and make changes to your Medicare health or prescription drug coverage for the upcoming year. If you’re living with kidney disease, on dialysis, or have a kidney transplant, it’s especially important to review your plan—coverage options, networks, and out-of-pocket costs can change yearly. The plan that worked for you last year might not be the best for the upcoming one.
What Could Change in 2025
Even if you’re happy with your current plan, it’s important to review it—many Medicare plans change each year. For 2025, you may notice updates in three key areas:
1. Plan Costs
Your total costs can shift from year to year. This includes the amount you pay each month for coverage (your premium) as well as the amount you pay out of pocket before coverage begins (your deductible)
2. Coverage and Networks
Check that your doctors, dialysis center, transplant hospital, and pharmacies are still in-network. This is especially important if you’re planning for a kidney transplant or need ongoing immunosuppressive medications, since some Medicare Advantage plans are more restrictive about which transplant centers and post-transplant care they cover.
3. Major Medicare Updates for 2025–2026
Medicare is rolling out several significant changes that can help lower your costs and make prescription drug payments more manageable:
Prescription Drug Cost Cap: Out-of-pocket spending for medications under Medicare Part D will now be capped, limiting how much you can pay each year.
Medicare Prescription Payment Plan: You’ll have the option to spread out your prescription costs evenly over the year instead of paying large amounts all at once. To use this feature, you must opt in to the program. Talk to your social worker or pharmacist for help enrolling.
Affordable Insulin and Free Vaccines: Insulin costs remain capped, and recommended vaccines continue to be available at no cost to you.
What You Can Do During Open Enrollment
Between October 15 and December 7, you can:
Switch from Original Medicare to a Medicare Advantage plan (a private Medicare plan).
Move from a Medicare Advantage plan back to Original Medicare.
Add, drop, or change a Medicare Supplement Insurance (Medigap) plan. Medigap can help cover the 20% coinsurance on dialysis treatments and other out-of-pocket costs under Original Medicare.
Join or switch to a Medicare Part D prescription drug plan.
Drop your prescription drug coverage if it no longer meets your needs.
Remember: People with ESRD who are covered by Medicare can get Medigap plans that help cover the 20% coinsurance on dialysis treatments in original Medicare. Not every state requires health insurance companies to sell supplemental insurance to people with ESRD under 65.
Get Help Comparing Plans
The social worker at your dialysis facility or transplant center can help you compare options and select the coverage that best meets your needs in the coming year.
You can also use these trusted resources:
State Health Insurance Assistance Program (SHIP) for free help with Medicare questions.
The Low-Income Subsidy (LIS) Program may help cover prescription drug costs for those who qualify. Ask your social worker about eligibility or apply online.
Raise Your Voice
Join Voices for Kidney Health to advocate for policies that protect and improve Medicare coverage for people with kidney disease.
Need Personalized Support?
Health coverage can be complicated, but help is available. Message or NKF Cares at 855.653.2273 for support from a trained professional.
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