It’s that time of year—the Medicare Annual Enrollment Period fast approaches (October 15—December 7)! With Medicare rolling out some big changes for 2025, it’s more important than ever to review your health coverage. Don’t let you or a loved one get caught by surprise out-of-pocket costs.
I’ve put together a helpful breakdown of the important Medicare changes for 2025.
Medicare Changes 2025 – Disruptions for Millions of Beneficiaries
In 2025, over 2 million seniors will find that their current Medicare plans are either discontinued or unavailable in their area; this includes more than 1.5 million individuals losing their Medicare Advantage and Part D Prescription Drug Plan (PDP) coverage. In addition, over 9.8 million beneficiaries will be transitioned to new plans with changes in benefits and higher Maximum Out-of-Pocket (MOOP)
This news will significantly impact millions of beneficiaries, but preparing for these changes can minimize any unexpected difficulties. Some of these disruptions are due to Medicare Advantage plans scaling back on extra benefits they’ve added in recent years. While changes like these aren’t frequent, staying prepared and proactive is important.
Medicare Part D: What’s Changing in 2025?
- A New $2,000 Cap on Prescription Drug Costs
Starting in 2025, Medicare Part D will implement a $2,000 annual cap on out-of-pocket prescription costs; this is part of the Inflation Reduction Act of 2022 and will be a major relief for many, as it limits how much you’ll spend on medications covered by your Part D plan. Remember, this cap applies to Part D drugs only and doesn’t cover costs for Medicare Part B drugs, such as vaccines and doctor-administered injections.
- Payment Flexibility for Prescription Costs
You’ll now have the option to spread your out-of-pocket prescription costs throughout the year. Instead of facing high costs all at once, you can pay a monthly bill for your Part D drugs; this makes budgeting for medication expenses more manageable and predictable.
- Enhanced Benefits Count Toward Your Cap
If your Part D plan includes supplemental benefits (such as coverage for non-standard drugs like those for hair growth), these will count toward your $2,000 out-of-pocket cap; this can help you reach the cap sooner, reducing overall costs.
- Mid-Year Notification of Unused Benefits
Beginning in 2025, Medicare Advantage plans will be required to send a Mid-Year Enrollee Notification in July. This notice will inform you of any supplemental benefits you haven’t used, along with details on how to claim them and the associated costs. This update helps ensure you don’t miss out on any plan perks.
Medicare Changes 2025: Review Your Annual Notice of Change (ANOC)
Given these significant changes, carefully reading your Annual Notice of Change (ANOC) letter is crucial! This document outlines the updates to your plan, including cost and coverage changes. If your plan is being discontinued or scaled back, take the time to explore alternative options to ensure your coverage continues to meet your needs.
Medicare Changes 2025: I’m Here to Help!
If you’re feeling overwhelmed by these changes or don’t quite understand how they will impact your Medicare coverage, don’t worry—help is available.
I work not only as a family financial planner but also as a Medicare advisor. I’m offering free Medicare reviews to help you understand how the 2025 updates will affect you and explore the best options for your coverage.
Also, throughout the enrollment season, I’m hosting an in-person workshop and two online webinar workshops to provide detailed information on these changes and answer any questions. Be sure to RSVP and secure your spot. Register below!
Register for the Medicare Workshop
To read more on Medicare, please see my accompanying articles:
