These 3 Changes Will Happen to Medicare in 2025. Are You Ready?

Millions of older Americans get health coverage through Medicare. But just because Medicare has been around for a long time doesn’t mean the program will never change. Here are some important updates for 2025 that every Medicare enrollee should know about.

1. A new $2,000 annual cap on out-of-pocket expenses for prescription drugs

Medicare Part D enrollees typically face huge out-of-pocket costs in the course of paying for prescriptions. But thanks to a new rule, some beneficiaries could be in for a treat.

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Starting in 2025, all Medicare Part D enrollees will have a $2,000 cap. Additionally, Medicare Part B and D enrollees who receive insulin through a pump will have their monthly cost capped at $35.

Even with these changes in place, it pays to shop carefully for a Part D drug plan during Medicare Open Enrollment, which begins this year on October 15th and runs through December 7th. knowing that their spending will soon have a limit.

2. A mid-year notice of benefits for Medicare Advantage subscribers

Seniors can choose between Original Medicare — Parts A and B, plus a Part D drug plan — or Medicare Advantage, which usually offers all-in-one coverage. The advantage of enrolling in Medicare Advantage is that these plans generally offer additional benefits beyond what Medicare originally covers. For example, Original Medicare doesn’t pay for dental care or eye exams, but many Medicare Advantage plans cover these critical services.

That said, additional benefits can vary from one Medicare Advantage plan to another. And enrollees who don’t know what those benefits entail could be missing out.

To address this issue, starting in 2025, Medicare Advantage plans will be required to send enrollees a personalized mid-year notice of unused supplemental benefits. This notice will list additional benefits available to plan participants and instructions on how to access them.

3. A new standard monthly premium for Medicare Part B

There is a cost associated with Medicare Part B that typically changes each year. Right now, the standard monthly premium for Part B is $174.70. In 2025, this premium is likely to increase, although we do not know the extent of this increase at this time.

This is important, however, because seniors who are enrolled in Medicare and Social Security at the same time have their Part B premiums automatically deducted from their monthly benefit payments. Meanwhile, initial Social Security cost-of-living adjustment (COLA) projections call for a smaller increase in 2025 than in 2024. But if the cost of Medicare Part B rises substantially, it could wipe out the minimum increase Social Security recipients receive. in the new year.

These are just a few of the changes that could be coming to Medicare in 2025. If you’re enrolled in Medicare, pay attention to updates so you know what to expect. And if you’re getting ready to enroll soon, it’s worth keeping an eye on Medicare news so you can get the most out of the program and avoid unpleasant surprises.