Medicare open enrollment is underway and Massachusetts residents over 65 are encouraged to consider their health plan options.

Changes this year include a $2,000 out-of-pocket cap on prescription drugs.

Cindy Phillips, director of the state's health insurance information program Serving the Health Needs of Everyone, which provides trained Medicare counselors, said the changes could bring significant savings.

"Whether it's a required brand name or generic, extended release or capsule," Phillips outlined. "All of these elements can influence the cost of the medication."

Phillips encouraged people to compare and contrast the plans available to them, making sure their provider and medications are covered. She pointed out counselors are available in nearly every Massachusetts town.

The cap on out-of-pocket drug care expenses takes effect Jan. 1 and is one of several changes made possible by the Inflation Reduction Act. Seniors will also see greater access to mental health services and increased protections from prior authorization practices.

Dr. Rhonda Randall, chief medical officer and executive vice president of UnitedHealthcare Employer and Individual, encouraged people to take advantage of the various perks many plans offer, including wellness benefits.

"You might find a health plan that will reward you for taking healthy actions," Randall explained. "Like completing a health survey, exercising, avoiding smoking, and many Medicare Advantage plans are going to cover a gym membership at no additional cost to you."

Randall added it is important people understand health insurance terms and take the time to comparison shop between Original Medicare and Medicare Advantage plans to ensure they provide individual coverage needs.

Research shows menopause can impact heart health, and the American Heart Association in Missouri is urging women to stay informed and take preventive measures during this stage of life.

Heart disease kills more women each year than breast cancer. The transition from the reproductive to non-reproductive phase usually starts in the late 40s to mid-50s, and brings changes in menstruation.

Before menopause, women produce estrogen, a hormone that may help protect the heart. As women go through menopause, their ovaries produce less estrogen.

Cardiologist Dr. Mozow Zuidema at Boone Hospital in Columbia shared some of the symptoms to look out for.

"Mood changes, sleep changes, sometimes central weight gain, in their body weight gain," said Zuidema. "So, it can lead to some either overweight characteristics or even obesity and can change their cholesterol profile."

In addition to getting regular screenings, the American Heart Association recommends regular exercise, a healthy diet and good sleep - to improve heart health before, during and after menopause.

After menopause, 25% of women may develop irregular heart rhythms known as atrial fibrillation, often linked to stressful life events.

Zuidema said another important key to staying healthy is to seek treatment early on.

"The earlier you get treatment for menopause, the better the outcomes are," said Zuidema. "Certainly, if a woman is through menopause before she starts, for example - hormone replacement therapy - then there's already some bone density loss and other characteristics."

Statistics show that just a little more than 7% of women in menopause meet physical activity guidelines, and less than 20% consistently follow a healthy diet.

Medicare open enrollment is underway and Maine seniors are encouraged to weigh the various plans.

Advisors say it's important to consider both healthcare and budget needs, and to read the annual notice of change - which should have already arrived in the mail.

Dr. Rhonda Randall, chief medical officer at UnitedHealthcare Employer and Individual, said it's important to make sure all providers and medications are still covered.

"Don't make this a last minute decision," said Randall, "It's way too much information, and it's an important decision to think about the health insurance coverage that you're going to have for next year."

Randall said it's important to know the differences between Original Medicare and Medicare Advantage - which may have additional benefits including dental, vision, and hearing.

She said counselors are available to help at medicare.gov.

More than 300,000 Mainers receive Medicare. One of the biggest changes they'll see this year is a new $2,000 out-of-pocket cap on prescription drugs under Part D.

Bridget Quinn, advocacy and outreach director with AARP Maine, said the savings are timely and important.

"So, we know the first top ten - which were some of the most costly drugs to Medicare - have been negotiated," said Quinn. "We do know what the prices are, and hopefully we're seeing that in 2025 some of those savings will be passed on to consumers."

People with Medicare Part D drug coverage now pay nothing out-of-pocket for even more vaccines, and monthly insulin costs are capped at $35.

Quinn said those savings mean people are more likely to take their medicine as prescribed and have their basic needs met.

She noted that for first-time Medicare applicants, the many healthcare and insurance terms can be confusing.

AARP has also created an online Medicare Resource Center to help people navigate the process.

Early voting kicks off in Texas today, and when voters cast their ballots, they'll vote for more than just the president.

They'll also pick members of the state legislature and members of Congress.

Brian Sasser is the chief communications officer for the nonprofit Episcopal Health Foundation, which works to address the non-medical aspects of health. He said people should consider a lawmaker's voting record when going to the polls.

"Voting shapes policies," said Sasser, "from healthcare access, food security, housing, all the other things - non-medical things - outside the doctor's office, that impact your health."

Early voting runs through Nov. 1. Election Day is Nov. 5.

A recent Episcopal Health Foundation survey found that 68% of Texans say the state isn't doing enough to ensure low-income adults can get the healthcare they need.

Almost 60% say the state isn't doing enough to help children.

Sasser said local and state lawmakers make many decisions that impact your overall health.

"You can also look at how they approach sidewalks in your community, how do they approach giving more people access to food vouchers," said Sasser. "It's more than just one single issue within health. Voting is part of being a member of the community and policies that are affected by voting affect your health."

The last day to apply for a ballot by mail in Texas is Friday, Oct. 25.