Medicare Open Enrollment 2025
In this blog post, we’ll cover key changes and essential information you need to know during this enrollment period. Plus, we’ll dive into a few new developments that will influence your Medicare choices.
1. Take Advantage of Telehealth Services
Here’s an important update: Until the end of 2025, you can continue to access telehealth services from anywhere in the U.S., even the comfort of your own home.
After this date, most telehealth services will require you to be in an office or a medical facility located in a rural area, with a few exceptions for mental health services.
2. Improved Mental Health Services
Starting January 1, 2025, Medicare will extend its coverage to include intensive outpatient program services for mental health care, provided by hospitals, community mental health centers, and other facilities.
This change represents a significant step forward in addressing mental health needs.
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3. Affordable Medicare Advantage Plans
The good news is that the average monthly premiums for Medicare Advantage plans are expected to increase by just $0.64, from $17.86 in 2024 to $18.50 in 2025.
Most beneficiaries who stay with their current plan will experience minimal to no premium increase, with around 73 percent seeing no rise in premiums.
Medicare Advantage enrollment is also expected to grow from 31.6 million in 2024 to 33.8 million in 2025, increasing the share of Medicare beneficiaries enrolled in Medicare Advantage from 48 percent to 50 percent.
4. Enhanced Medicare Advantage Plans
Medicare Advantage premiums remain stable, and more than 1,500 plans representing 8.7 million beneficiaries will participate in the CMS Innovation Center’s Medicare Advantage Value-Based Insurance Design (VBID) Model in 2025.
This model improves access to supplemental benefits that address social determinants of health, especially for those with chronic conditions or low incomes. Nearly 80 Medicare Advantage plans will also offer the VBID Model’s Hospice Benefit Component, increasing access to palliative and integrated hospice care.
5. Improved Drug Coverage
Starting January 1, 2025, if you have Medicare drug coverage (Part D) and your drug costs reach the catastrophic coverage phase, you won’t have to pay copayments or coinsurance.
Extra Help, a program that helps cover your Part D drug costs, will expand to cover more drug expenses for certain individuals with limited resources and income. Some Part B-covered drugs may also have reduced coinsurance amounts if the drug’s price increases higher than the rate of inflation.
6. Lower Part D Premiums
In July, the Centers for Medicare & Medicaid Services (CMS) announced that the average monthly premium for Medicare Part D coverage is projected to be $55.50 in 2025, a 1.8 percent reduction from $56.49 in 2024.
Additionally, Part D beneficiaries can look forward to lower drug costs, thanks to provisions in the Inflation Reduction Act, including a $35 cost-sharing limit on a month’s supply of covered insulin products.
Beneficiaries may also receive extra financial support through the Medicare Savings Program and the Low-Income Subsidy Program. In 2025, the Low-Income Subsidy Program will expand to allow eligible beneficiaries to have no deductible, no premium, and fixed lower copayments for specific medications.
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7. Cap on Part D Out-of-Pocket Spending
In 2025, Part D enrollees without low-income subsidies will no longer be required to pay 5% of their drug costs once they reach the catastrophic threshold, which will be set at $8,000.
This threshold includes what Part D enrollees spend out of pocket plus the value of the manufacturer price discount on brand-name drugs in the coverage gap phase.
8. Stay Informed with Annual Premium Updates
Keep an eye out for the annual release of the MA & Part D Landscape in September, which will provide essential information, including the projected average total Part D beneficiary premium, projected to decrease by 1.8% in 2025.
In conclusion, Medicare’s open enrollment for 2025 presents numerous opportunities to optimize your healthcare coverage. By staying informed and taking advantage of these changes, you can ensure you make the most cost-effective and beneficial choices for your health and well-being.
Here are some additional blogs for further reading: Medicare Open Enrollment – What’s It All About? | Medicare Supplement and Medicare Advantage Plans: Which Are Better?
Here are some additional pages related to this article: Medi-Share 65+ | Medicare Advantage Plans
Wiley Long is founder and president of Medigap Advisors, and is passionate about helping people navigate the confusing waters of Medicare. He is the author of The Medicare Playbook: Designing Your Successful Health Coverage Strategy, a clear and simple explanation so you can make the most of your Medicare coverage.