Medicare Open Enrollment for 2025

It is my pleasure to assist you with your questions! I often receive the same inquiries every year, which is why I regularly address them on our blog. My goal is to reach as many of you as possible—there are many of you, and just little old me! To recap, I was a certified California Health Insurance Program counselor for over five years. I have also worked as a Revenue Cycle Manager, Compliance Officer, and a California Medical Board-approved Billing Monitor in the healthcare industry. I hope you find the information here valuable and helpful. Please visit our website, cpappro.com, for more details, including samples of what a Medicare Advantage (MA) insurance card looks like compared to a Traditional Medicare (TM) card.

If you haven’t already, you will soon receive the "Medicare & You" booklet. In the coming weeks, there will be an influx of commercials promoting Medicare Advantage Plans, all promising extra benefits if you sign with their plan. However, each individual and couple has unique circumstances that need to be considered. My suggestion, as always, is to take a moment and write down the information specific to your situation. Document your prescriptions, whether they are for Durable Medical Equipment (DME) or medications. Do you need a specialist, or is your primary care doctor sufficient for your needs? Do you require routine visits for vision, hearing, or dental issues? Once you’ve outlined these details, you can more easily identify the best Medicare option for you.

As a reminder, Medicare allows you to receive a CPAP machine every five years. While accessories have different replacement frequencies, for your CPAP Pro – maskless CPAP, Medicare covers one mask every 90 days and up to two pairs of nasal pillows per month.

Additionally, if you choose to switch from a Medicare Advantage plan back to Traditional Medicare during Open Enrollment, you can. You have until March of the following year to make that decision. You can also make changes within Open Enrollment, as long as you do so before it ends. I’ve mentioned this before, but it’s worth repeating: your local State Health Insurance Program (SHIP) is a valuable free resource. Certified counselors can help you explore the options in your area and assist with any billing concerns. Whether you choose MA or TM, the decision is yours, without the pressure of an insurance agent.

Finally, if we are billing Medicare for your CPAP Pro mask and other accessories, please keep in mind that we do not bill Medicare Advantage plans. Every year, some patients switch to MA plans, only to realize that it’s not the same as Traditional Medicare, leaving them struggling to find a DME supplier that accepts their new coverage. We aim to avoid this by being transparent upfront, so you can make informed decisions about your coverage for next year.

Wishing you the best during the holiday season, and here’s to a good night’s sleep! Keep an eye out for our holiday specials, and as always, feel free to submit your questions—we’re here to help!