Millions of older Americans receive health coverage through Medicare. But just because Medicare has been around for a long time doesn't mean the program never changes. Here are some important updates for 2025 that every Medicare enrollee should be aware of.
1. A new $2,000 annual cap on out-of-pocket prescription-drug spending
Enrollees in Medicare Part D commonly face tremendous out-of-pocket costs in the course of paying for prescriptions. But thanks to a new rule, some beneficiaries may be in for relief.
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Starting in 2025, all Medicare Part D enrollees will have their out-of-pocket prescription-drug costs capped at $2,000. Furthermore, enrollees in Medicare Parts B and D 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's open enrollment , which begins this year on Oct. 15 and runs through Dec. 7. But Medicare enrollees with high-cost prescriptions can take comfort in knowing that their spending will soon have a limit.
2. A midyear benefits notification for Medicare Advantage enrollees
Seniors can choose between original Medicare -- Parts A and B, plus a Part D drug plan -- or Medicare Advantage, which commonly provides all-in-one coverage. The benefit of signing up for Medicare Advantage is that these plans generally offer supplemental benefits beyond what original Medicare 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, supplemental benefits can vary from one Medicare Advantage plan to another. And enrollees who don't know what those benefits entail may lose out on them.
To solve that problem, beginning in 2025, Medicare Advantage plans will be required to send enrollees a personalized midyear notice of unused supplement benefits. That notice will list the added benefits available to plan participants, as well as instructions on how to access them.
3. A new standard monthly premium for Medicare Part B
There's a cost associated with Medicare Part B that commonly changes every year. Right now, the standard monthly Part B premium is $174.70. In 2025, that premium is likely to rise, although we don't know the extent of that increase at the moment.
That's important, though, because seniors who are enrolled in Medicare and Social Security at the same time have their Part B premiums deducted automatically from their monthly benefit payments. Meanwhile, initial Social Security cost-living-adjustment (COLA) projections are calling for a smaller raise in 2025 than in 2024. But if the cost of Medicare Part B increases substantially, it could eat away at what minimal raise that Social Security recipients get in the new year.
These are only some of the changes that may arrive for Medicare in 2025. If you're enrolled in Medicare, pay attention to updates so you know what to expect. And if you're gearing up to enroll soon, it pays to keep tabs on Medicare news so you're able to make the most of the program and avoid unpleasant surprises.
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