Medicare beneficiaries can expect changes in 2025, according to the Centers for Medicare & Medicaid Services (CMS). While specifics for Parts A, B, and C are still pending, details about Part D plans have been released. Part A, which covers inpatient care, is free for most beneficiaries who paid Medicare taxes while working.
Part B, covering medical services like doctors’ visits and outpatient care, has a premium of $174.70 per month in 2024. Updates for both will be announced in the fall. Medicare Advantage, or Part C, offers additional coverage through private companies.
In 2025, enrollees will receive a mid-year notification about unused benefits to help them make informed decisions during reenrollment. Significant changes are coming to Part D in 2025. The base beneficiary premium will increase by $2.08, from $34.70 to $36.78.
A new $2,000 out-of-pocket maximum per year for medications will be introduced, benefiting those who need expensive medications regularly. The Part D coverage gap, known as the donut hole, will be eliminated.
Expected Medicare Part D alterations
Participants will only pay their deductible (up to $590) and copayments until reaching the $2,000 out-of-pocket maximum. A new optional payment plan will allow enrollees to spread out medication payments throughout the year instead of paying up front. This opt-in plan aims to ease the financial burden on beneficiaries.
As the 2025 Medicare Annual Election Period (AEP) approaches, industry veterans shared insights during an Aug. 22 webinar. Lauren Flynn Kelly, a health business issues expert, emphasized concerns about how plans are adapting to the new regulatory environment and the role of brokers during this transition.
Kelly noted that the upcoming changes could significantly influence the market, advising brokers and agents to stay informed and agile. Medicare Advantage plans and brokers must prepare for the unexpected and stay proactive to maintain their competitive edge. The Annual Notification of Change (ANOC) booklet, sent to Medicare beneficiaries every September, is especially important this year due to the changes prompted by the Inflation Reduction Act (IRA) of 2022.
Key aspects to look for in the ANOC booklet include premium changes, prescription drug coverage modifications, and adjustments to extra benefits offered by Medicare Advantage plans. Beneficiaries are encouraged to thoroughly review their ANOC information and consider making changes to their plan during the annual enrollment period from October 15 to December 7.
- CNET.”Medicare Prices Are Going Up in 2025: Here’s How Much”.
- MMITNetwork.”Industry Veterans: As Disruptive AEP Nears, Brokers Can Be Critical Plan Partners”.
- CourierJournal.”ANOC Booklet”.