Medicare Changes on the Horizon: What to Expect in 2025. How will it effect you and what can you do?

The Inflation Reduction Act (IRA) is set to bring significant changes to Medicare in 2025. These changes aim to lower prescription drug costs, protect beneficiaries, and improve the overall Medicare program

Key Changes Coming in 2025

$2,000 Out-of-Pocket Cap: One of the most significant changes is the implementation of a $2,000 annual out-of-pocket cap for prescription drug costs. Once you reach this limit, Medicare will cover 100% of your drug costs for the rest of the year. This will provide much-needed relief for those with high prescription drug expenses.   Drug Price Negotiations: The IRA allows Medicare to negotiate drug prices for certain high-cost medications.While the full impact of this provision may take time to materialize, it has the potential to lower drug costs overall.

Other Changes include the Elimination of the Coverage Gap (Donut Hole), Lower Insulin Costs ( $35 per month) and Free Vaccines. Read more HERE.

However, as the medication cost is capped at $2000, that means that insurance companies will have to absorb some of that cost.

How will it effect you?

Medicare Advantage members: Early news is that to save on costs, some of the added benefits may be reduced. 

If you have a Medicare Supplement Plan and a Part D Prescription drug plan, we can assume that the monthly premiums will increase next year on your Part D plan.

What should you do?

Take advantage of your extra benefits on your medicare Advantage plans this year. i.e Dental & Vision benefits. That's a good practice even if the benefits don't go away next year. :)

Companies have NOT released their plans or premiums for 2025 yet. We will have detailed information to share during Open Enrollment i.e October 15 through December 7. Please schedule a call with me with me during that time.

Look out for communications from your health plan. In September you should receive your Annual Notice of Change. This document will spell out any changes in your plan.

Join me

If you live in the Westside, I will be doing an Free in-person presentation on the Basics of Medicare and go over the upcoming changes for 2025 at the Elks Lodge Westchester On September 25th.  I promise to make it informative and fun. Please RSVP here.

PS: Pizza and raffle prizes included. :)