Medicare Changes for 2025

INSURANCE - Hey, if you wanna know what’s new for Medicare in 2025, I did some checking:

Medicare is introducing several important changes in 2025 that will affect coverage and costs, particularly within Medicare Advantage and Part D plans:

1. $2,000 Out-of-Pocket Cap for Prescription Drugs: A major update for 2025 is the introduction of a $2,000 annual cap on out-of-pocket expenses for prescription drugs covered under Medicare Part D. This cap is designed to alleviate the financial burden on beneficiaries by limiting their prescription drug costs throughout the year).
2. Elimination of the Coverage Gap ("Donut Hole"): The traditional coverage gap in Medicare Part D, often referred to as the "donut hole," will be eliminated. Previously, beneficiaries would enter this phase after spending a certain amount on drugs and would then face higher costs for medications until reaching catastrophic coverage. Starting in 2025, this gap will no longer exist, simplifying the coverage phases to just a deductible and then standard copayment or coinsurance up to the out-of-pocket cap​).
3. Expanded Access to Behavioral Health Services: There will be improved access to mental health services through Medicare plans, with more types of providers, such as mental health counselors, being encouraged to enroll as Medicare providers. This expansion aims to provide better support for beneficiaries needing mental health care​).
4. Mid-Year Benefit Notifications for Medicare Advantage: Starting in 2025, Medicare Advantage plans will be required to issue a mid-year notification to policyholders about their unused supplemental benefits. This aims to help beneficiaries better utilize the benefits available to them, such as dental, vision, and hearing services​).

These changes reflect ongoing efforts to improve the affordability and accessibility of healthcare for Medicare beneficiaries. It's important for those enrolled or considering enrollment to review their plan options during the open enrollment period to ensure they choose a plan that best fits their healthcare needs and budget in light of these changes.

(Jim Hampton is the Publisher and Editor of CityWatchLA.com.  Jim has over 40 years experience in radio broadcasting, marketing and content creation.  He helped Ken Draper to launch CityWatch on the web over 20 years ago.)