Prepare for Medicare 2025
Thanks for being a returning EssentiaCare member! We’re so glad you’re here and look forward to helping you get the most out of your plan.
Your Medicare guide for the year ahead
Consider this your home base for everything you need to take advantage of your EssentiaCare plan. Review the timeline to learn what information to expect and when. We've got you covered — for 2025 and beyond.
Love what you've got? You don't need to do anything to keep your current EssentiaCare plan for 2025.
What to expect
Late September
Annual Notice of Changes (ANOC) mailing
Includes your 2025 premium, changes to benefits and new plan features.
October 1
2025 plan information is available
Explore updated plan information for the new year.
Early October
EssentiaCare Annual Enrollment Notice for 2025
Includes current coverage details, plan options and helpful enrollment information.
Mid-December
EssentiaCare member guide
An overview of your 2025 EssentiaCare plan benefits, programs and features.
Medicare Annual Enrollment Period is October 15 – December 7, 2024.
Explore what's new with your plan
Beginning January 1, 2025, the following plan benefits and features will go into effect for EssentiaCare plans:
Coverage gap update
The Medicare Part D coverage gap, or the "donut hole," will be removed. You won't pay additional costs for your covered Part D drugs once you reach the maximum out-of-pocket costs of $2,000.
Lower out-of-pocket max on drug costs
The maximum out-of-pocket costs for your prescription drugs will decrease from $8,000 to $2,000. Once you've reached this amount in annual prescription drug spending (excluding EssentiaCare's cost), you pay $0.
Medicare Prescription Payment Plan
Using your dental benefits
Watch and discover
Check out these short videos to learn more about the benefits and programs that come with your plan.What's new in 2025
Explore important changes for the year ahead, including updates to pharmacy coverage, dental benefits, allowances and more.
Healthy Benefits+ Visa® card
Plan resources
Medicare drug list
Review the formulary (list of covered drugs) to find information about your prescription drugs and copay or coinsurance amounts.
In-network providers and clinics
Find out if your doctor or clinic is in your plan's network by using our online search tool. Choose your specific plan from the “Pick your plan” menu and search for doctors, hospitals and more. Narrow your search by choosing a specialty, location or other options.
Coverage when traveling
Learn how to use your coverage when traveling with access to out-of-state providers through our partnership with the national MultiPlan Network.
Plan documents
Select your plan to find your Summary of Benefits, EssentiaCare member guide, Evidence of Coverage, Enrollment Change Form and more.
Member plan comparison chart
Compare plan benefits and features with your current plan if your health needs have changed.
Access your online member account
Sign in or create a secure online member account. If your plan covers more than one person, each person will need a separate login ID and password for privacy and convenience. Have your full EssentiaCare member ID number available when creating your account. That number is on your member ID card or can be provided by calling customer service.
Benefits of having an online member account
- Send and receive secure messages with customer service and a web nurse
- Download or request a physical member ID card
- Access important health and wellness information
- Manage your contact information
- Pay your monthly plan premiums online and view your premium invoice and payment history
- View and track your claims, including Explanation of Benefits documents