Expect These Medicare Changes in 2025

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TL/DR –

The Centers for Medicare & Medicaid Services (CMS) is preparing for changes to Medicare in 2025, with details about Medicare Part D plans available and information about Parts A, B, and C to follow. Changes are related to the 2022 Inflation Reduction Act, which may impact the cost of medications for participants. Significant changes include a $2,000 out-of-pocket maximum for medication under Part D, the removal of the Coverage Gap (also known as the doughnut hole), and the introduction of a new medication payment plan option that allows beneficiaries to spread payments throughout the year.


Upcoming CMS Changes to Medicare in 2025

The Centers for Medicare & Medicaid Services (CMS) is outlining changes to Medicare in 2025. Currently, CMS has provided details on modifications to Medicare Part D plans, with information on Parts A, B, and C expected soon. Notably, more rules from the 2022 Inflation Reduction Act will be enacted in 2025, potentially transforming what participants pay for medications.

Annual CMS Adjustments to Medicare Costs

The Social Security Administration determines the annual costs of the Medicare program. These costs then translate into either increased or decreased premiums and deductibles. The CMS will be providing updates on the 2025 changes to Medicare in the coming weeks and months.

Expected Changes to Medicare in 2025

While we await the full details of Medicare changes for 2025, there are some anticipated adjustments. For additional resources, refer to the Social Security payment schedule and ways to secure your Social Security benefits.

Changes to Medicare Parts A, B, and C

Medicare Part A covers inpatient care in hospitals and skilled nursing facilities. Almost 99% of beneficiaries receive Part A for free. Medicare Part B covers doctors’ services and outpatient care, with the 2024 premium at $174.70 per month. Updates to Medicare Part C (Medicare Advantage) are expected to include a mid-year notification for participants about any unused benefits.

Medicare Part D Changes in 2025

Part D helps cover prescription drug costs. Several changes are expected due to the Inflation Reduction Act. The base premium is projected to increase by $2.08, or 6%, from $34.70 to $36.78. There’ll be a new $2,000 out-of-pocket maximum per year for medications, which may greatly benefit those with high-cost monthly medications. The Coverage Gap (doughnut hole) will be eliminated, simplifying coverages while implementing a new medication payment plan option.


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