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What You Need to Know: Medicare Prescription Drug Plan Open Enrollment 2025

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Open Enrollment for Medicare Part D (prescription drug coverage) is here again, running October 15 – December 7, 2025, for the 2026 plan year. This year is especially complicated: some plans are disappearing, premiums are changing, and deductibles are shifting. If you (or a family member) rely on Medicare prescription drug coverage, here’s a roadmap to make sure you’re in the right plan for 2026.

Step 1: Go to Medicare.gov

The most reliable tool is right at your fingertips: Medicare.gov.

  • Click “Find Plans”
  • Enter your ZIP code, pharmacy, and your prescription drugs
  • Medicare’s tool will show you which plans cover your drugs, at what cost, and with which pharmacies.

This is critical — don’t guess. Plans differ dramatically in how they treat the same drug.

Step 2: Understand the Deductible Rules

For 2026, many California drug plans will come with a $615.00 deductible (that’s the amount you pay out-of-pocket before the plan starts sharing costs). But plans apply this deductible differently:

  • Some plans apply the deductible to all drug tiers (including generics).
  • Others apply it only to brand-name or higher-tier drugs.

Translation: If you mostly take Tier 1 or Tier 2 generics, you may find a plan where your deductible doesn’t apply — so you get co-pays right away.

Step 3: Compare Your Choices Before December 7

You must make your decision by December 7. After that, you’re locked in (or out) until the next Open Enrollment. Here’s what to look at when comparing plans:

  • Monthly premium (what you pay each month for the plan)
  • Deductible (what you pay before coverage kicks in)
  • Drug costs (your co-pay or coinsurance for each medication)
  • Pharmacy network (make sure your preferred pharmacy is covered)
  • Customer service reputation (some carriers are much easier to work with)

Step 4: Two Options Worth Highlighting in California

  • WellCare Value Script – This is typically the lowest-cost plan for many Californians. It offers low or $0 co-pays for Tier 1 and Tier 2 generics, which makes it attractive if you only take a few basic medications. $5.70 a month
  • HealthSpring (formerly CIGNA) Extra RX – likely the best bet for those with multiple drugs and access to some Teir 1 and Tier 2 drugs before the deductible. $70.60 a month
  • AARP MedicareRx Preferred – While more expensive, this plan usually has the broadest formulary (drug list) and better customer service. If you’re on multiple or brand-name medications, this plan may be worth the peace of mind. $165 a month

Step 5: Don’t Wait Until the Last Minute

Every year, people put this off until December and end up rushing. Do yourself a favor:

  • Run your drugs on Medicare.gov now.
  • Select a plan and enroll online – or you can call the carrier directly to discuss access to a specific drug.
  • Enroll before December 7 to avoid surprises.

A Word About Agents

Unlike Medicare Advantage or Medigap plans, Part D prescription drug plans are not agent-driven products. That means licensed insurance agents can’t really “fix” or “customize” your drug plan. Think of agents like people patching flat tires — we can advise you, but the enrollment is really up to you, directly through Medicare.gov or the plan.

Bottom Line

For 2025, Medicare drug coverage in California is more complex than ever. Some plans are disappearing, prices are shifting, and deductibles are higher. The good news: if you take 30 minutes to use the Medicare Plan Finder tool, you can make sure you’re not overpaying and that your drugs are covered the way you need.

Deadline: December 7, 2024. Don’t miss it.

Year-End Health Insurance Planning: The Annual Rush Is Here

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Every year as we approach the end of the calendar, the health insurance world goes into overdrive. Employers, employees, retirees, and individuals alike are all swept into a narrow window where critical choices must be made.

This is the season where the industry feels like organized chaos — with deadlines stacked against holidays and big decisions that can’t wait.

Employers: Annual Open Enrollment Crunch

For almost every employer, the end of the year means annual open enrollment. This is the time to:

  1. Review company health plans and offerings for 2026
  2. Decide on cost-sharing strategies and benefits packages
  3. Communicate changes to employees
  4. Allow staff to choose from multiple health and voluntary plans

All of this has to be done in a compressed timeframe, often while HR teams are juggling other year-end priorities. One missed detail can ripple into a year’s worth of employee frustration or unexpected costs.

Medicare Beneficiaries: Critical Choices

For individuals eligible for Medicare, the end of the year also means a chance to reevaluate coverage. Two big areas are front and center:

  1. Medicare Advantage (HMO) plans – Reviewing networks, benefits, and costs and electing a plan for 2026
  2. Prescription Drug (Part D) plans – Facing radical pricing increases in 2026, with many plans being discontinued altogether and most will have to carefully review their choices and make a new election

This year is shaping up to be especially tumultuous, with plan cancellations and higher drug costs driving the need for proactive reviews. Doing nothing could leave beneficiaries exposed to higher out-of-pocket costs or potentially without adequate coverage.

Exchange / Covered California Enrollees: Rising Costs Ahead

For those insured through the Affordable Care Act exchanges (ObamaCare) or Covered California in California,, 2026 brings more uncertainty:

  1. Large premium increases in many markets
  2. Potential loss of subsidies if federal funding lapses, driving up net costs for families
  3. Shifting plan designs that may increase deductibles and out-of-pocket expenses

This means individuals and families need to move quickly, shop carefully, and understand how policy changes may affect their bottom line.

Why Action Is Urgent

The theme across all groups is clear: don’t wait. Whether you’re an employer setting strategy, a Medicare beneficiary evaluating drug coverage, or an individual buying through Covered California, the clock is ticking.

Complicating matters is the fact that this all collides with the holiday season — a time when people are distracted, offices are short-staffed, and advisors (like us) are managing a flood of client needs. Waiting until the last minute only adds stress and reduces your options.

How We Can Help

We’re here to help navigate this storm. Whether it’s clarifying plan options, running cost comparisons, or walking through Medicare drug plan changes, our team is on the front lines.

Our advice:

  1. Don’t delay — start your review now.
  2. Ask questions early.
  3. Make decisions with full information, not in a last-minute rush.

And remember: at CorpStrat, we’re managing a very high volume of requests, so reaching out sooner rather than later gives us the best chance to help you smoothly.

Bottom line: This year’s end-of-year planning season will be hectic, complex, and unforgiving of delays. Don’t risk being caught off guard. If you need guidance, reach out today — before the holidays and deadlines take over.

5 Ways CorpStrat Outshines Other Benefits Brokers

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As the Fall season approaches, we’re excited to present you with five compelling reasons to continue partnering with CorpStrat for your Fall benefits. Your benefits plan is a crucial aspect of your company’s well-being, and our dedication to excellence ensures that you receive the best service possible.

1. Expertise that Shines: Unveiling the Brilliance of CorpStrat’s Cutting-Edge Brokerage

Our reputation within the industry is a testament to our expertise. Recognized as a top-tier broker by reputable carriers such as Anthem and Blue Shield, we possess the insights needed to optimize your benefits offerings. Let’s discuss strategies that can lead to substantial savings, like the Anthem plan, potentially reducing costs by 20% or more annually.

2. A Human-Centered Approach: CorpStrat, Where Your Team’s Well-Being is Paramount

At CorpStrat, you’ll never be met with automated responses. Our commitment to personalized interactions ensures that you receive tailored solutions that align with your specific requirements. Navigating the complexities of healthcare and insurance is seamless with our engaged and attentive team.

3. Streamlined Digital Enrollment: A Paperless and Convenient Future

Transitioning to digital enrollment eliminates administrative hurdles. Our Ease platform offers a user-friendly experience, making enrollment hassle-free and environmentally responsible. Bid farewell to paper-based processes and embrace streamlined digital solutions.

4. Unleashing Creativity: Innovative Benefits to Elevate Your Team

Our commitment to your success means thinking outside the box. Imagine the potential of providing your key team members with guaranteed acceptance Life Insurance, all without the hassle of underwriting or setting up a private company foundation. Our creative ideas and strategic planning aim to elevate your benefits program to new heights.

5. Compliance Excellence: Staying Ahead of Regulations

Navigating complex compliance requirements is a challenge we’re well-prepared for. We keep you updated with cutting-edge compliance solutions, including ERISA, COBRA, and various pre-tax programs, ensuring your peace of mind.

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Your continued trust is vital to us. With a client retention rate exceeding 95%, our track record speaks for itself. We’re here to ensure your benefits experience is second to none.

Let’s continue our journey together. Should you have any questions or wish to discuss your Fall benefits strategy, please don’t hesitate to reach out.

6 Common Mistakes to Avoid When Choosing a Health Plan

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Health insurance may be one of the most critical annual purchases since it impacts your physical, mental, and financial wellness. Unfortunately, selecting a health insurance plan can feel overwhelming. With so many options, it can also be easy to make a mistake when selecting coverage.

This article explores six common missteps related to selecting a health insurance plan. Once armed with this information, it’ll be easier to avoid these mistakes and choose the best plan coverage for your situation.

Mistake #1: Rushing Through Enrollment Options

Many people rush when buying their health insurance or only rely on recommendations from friends, family and co-workers. Others may simply re-enroll with last year’s choices. But health insurance provides personal coverage, so it’s important to research and find what will work best for your health needs and budget. Read our full blog post to learn what to look out for before you finalize your decisions.

When it comes time to enroll in a plan, compare different policies and understand their coverages and associated costs (e.g., premiums). One of the best ways to ensure the policy is right for your health needs is to consider your medical requirements and spending in the next year. Don’t forget to confirm in-network coverage to ensure that your preferred doctor, clinic, and pharmacy is connected in the new plan. Then, you can find the most suitable plan and coverage in an effort to simplify your health care and make it more affordable.

Mistake #2: Overlooking Policy Documents

A lot of people skip through or don’t thoroughly read the policy’s terms and conditions. But often this is the best way to know what to expect from your health plan and what the plan expects of you. Don’t forget to read the fine print on each plan you consider to avoid surprise bills later on. Reviewing the policy’s inclusions and exclusions will help you make an informed decision that’s right for you.

Mistake #3: Misunderstanding Costs

Plans typically have a deductible, copays and coinsurance. Here’s what those terms mean:

The deductible is the amount you pay out of pocket before your health insurance starts to cover costs. A copay is a flat fee you pay upfront for doctor visits, prescriptions and other health care services. Coinsurance is the percentage you pay for covered health services after you’ve met your deductible.

When shopping for a plan, keep in mind that the deductible is tied to the premium. A low deductible plan may seem attractive until you understand that it generally comes with a higher premium—and vice versa. When shopping for a plan, look closely to see when you’ll have a copay and how much it will cost for various services.

Mistake #4: Concealing Your Medical History

It may be tempting to avoid sharing your medical history if you’re worried about being rejected or receiving higher premiums. However, it could hurt you in the long run when insurance claims are denied for existing conditions or undisclosed medical information.

Mistake #5: Ignoring Add-ons

Health insurance add-ons are often included separately and require an additional premium, which means many people don’t look at them. A standard health insurance plan may not cover certain situations, so reviewing all available options is essential. An insurance add-on could help bolster your overall health insurance coverage by offering extra protection.

Review the add-on covers offered with your health insurance policy and see if any would be helpful for you, your family or plans in the next year. Some common add-ons include critical illness insurance, maternity and newborn baby insurance, hospital daily expenses and emergency ambulance services.

Mistake #6: Selecting Insufficient Coverage

People may hold back on purchasing certain coverage to pay a lower premium. While that may seem advantageous in the short term, you’ll be on the hook for out-of-pocket costs when facing a medical emergency. This mistake may be accompanied by physical, mental and financial health consequences.

When selecting a plan, check that the policy provides adequate coverage for your medical needs and other essentials. The right health insurance can take care of yourself and ensure financial security.

Summary

Health insurance is an essential investment for you and your family. By avoiding common mistakes while buying health insurance, you’ll be better informed to enroll in a plan and other coverages.

As health care costs continue to rise, it’s more important than ever to carefully review available policies, consider your options and health needs, and, ultimately, select the best plan to protect your health and finances.

If you have more questions about health plans, contact your manager or HR.

How to Encourage Employee Healthcare Comparison Shopping

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It’s a tough time for a lot of people out there: inflation is driving up the cost of everything from food to gas and your employees are feeling the sting. But even if this is the case, most Americans don’t realize they can comparison shop to make sure they’re getting the best price for their healthcare services. A survey from AKASA, a healthcare artificial intelligence company, revealed that nearly two-thirds (64%) of Americans have never tried to find the price of a specific healthcare service.

Paying more for healthcare doesn’t necessarily mean higher quality service or better outcomes. This is why shopping around for healthcare is so important, it can result in cost savings for both employees and employers. Today we’re going to talk about strategies employers can use to encourage employees to shop for high-value healthcare, which can help lower your organization’s health care costs.

1. Educate Employees

One of the first steps in helping encourage employees to shop around for healthcare is education. Employers have a unique opportunity to provide data and information to help employees understand the savings potential of healthcare comparison shopping.

Specifically, employers can help employees understand price variation and explain how to best shop around. According to Healthcare Bluebook data, U.S. healthcare prices vary an average of 650% for the same procedure. That’s a huge variance. 

Additionally, the federal government has started increasing price transparency for health care services, which can help with comparison shopping. For example, new rules require hospitals to post pricing online for various services and procedures. Starting next year, health insurers must share their negotiated prices with the public. So, as health care pricing gets more transparent, employers can really help employees better understand these price lists. 

2. Provide Transparency Tools

Employers can direct employees to user-friendly tools that break down pricing. Employers should connect with their benefits partners to understand what resources and transparency tools are already available for their employees. Some of these you’re already paying for but aren’t utilizing. There are also state-sponsored resources that offer tools to help consumers compare hospitals, health care facilities, and other providers in their state.

It’s essential to explain that if high healthcare costs are left unchecked, employees may experience reduced benefits or increased employee cost sharing. Of course, savings can help the organization, but it’s important to highlight how employees individually benefit.

3. Incentivize Behaviors

Another way to help make healthcare shopping top of mind for employees is to create rewards for certain consumer behaviors. Employers can create incentives for employees that use employer-provided price transparency tools to comparison shop for services and procedures.

Some employers may offer cash incentives, while others offer wellness program points. For example, wellness points could be redeemed for health savings account contributions or reduced cost sharing. As with any organizational initiative, employers should consider making it fun. Gamification (e.g., point scoring and social connection) can help facilitate friendly competition and increase employee engagement and motivation.

Conclusion

Healthcare costs are undeniably going to continue rising. Employers will need to take proactive approaches to reduce these costs. They have an opportunity to make employees feel empowered to take charge of their health and actively comparison shop for quality healthcare at the best price. A mix of education, provision of tools and incentivization may be the magic combination to help change employees’ health care shopping behaviors.

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If you’re interested in learning more about this, give us a call. We’re here to help.  

6 Tips for a Pain-Free Open Enrollment

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Is there such a thing as a pain-free Open Enrollment? We think so.

Many employers are under the impression that they have their Open Enrollment process down, but studies show that about 41% of employees feel the Open Enrollment process at their company is extremely confusing. Benefit renewal happens to occur during the busiest time of the year: the holidays. This means employers are taking time off to be with their families, have lengthy vacations planned, and year-end deadlines might be overwhelming them. In short, you don’t have your employees’ full attention and that can make a tricky process even more daunting.

Having a plan for a successful benefits Open Enrollment requires both planning and the proper tools. Here are our top tips to guarantee a pain-free Open Enrollment:

1. Have a clear plan.

Work closely with your insurance advisor to review options and plans and decide what you are going to do for the next calendar year.

2. Clarify employee contributions.

Review and revise any contribution formulas so employees know what their share of the costs are.

3. Review ancillary benefits.

Make sure you have assembled and reviewed all ancillary benefits that you can add to your plan. Plans like AFLAC, Dental, cafeteria, or voluntary insurance programs can really make your plan options vibrant.

4. Utilize technology.

Be sure you are using technology to communicate your offerings. If you are still using paper, please talk to us.)

5. Communicate offerings clearly.

Host a Zoom with your team so you can share the benefits and value propositions you are offering. Employee Benefits represent the second or third largest line item that companies spend. It would be foolish not to take advantage of sharing how great your company’s offerings are.

6. Make sure Payroll is squared away.

Be sure to work closely with your Payroll team to indicate any contributions and review your plans monthly as contributions for dependents can age up during the year.

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If CorpStrat isn’t your broker, please be sure to reach out to us and see how we can help you maximize the value of your offerings. Contact us at marketing@corpstrat.com.