The Financial Guys

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Changes Coming to Medicare in 2025 | What These Changes Mean for You

With the Medicare Annual Election Period (AEP) quickly approaching, the Centers for Medicare & Medicaid Services have announced major changes for 2025. How will this impact your healthcare coverage? Co-pays? Part D prescription cost? Benefits? 


Starting January 2025, there will be a $2,000 annual maximum on out-of-pocket prescription costs. Generally speaking, in the past, once your out-of-pocket spending on prescriptions reached about $3,300, you would enter “catastrophic coverage” and pay 5% of all your drug costs. In 2024, once you’ve entered catastrophic coverage, you pay nothing for your Part D drugs for the remainder of the year. 


Thanks to the Inflation Reduction Act of 2022, in 2025, individuals with Part D plans won’t have to pay more than $2,000 in out-of-pocket costs. This rule excludes Part B drugs, which typically include vaccinations, injections administered by a doctor, and outpatient prescription drugs. The $2,000 limit will adjust annually based on increases in per capita Part D expenses, potentially increasing annually after 2025. 


Experts anticipate that certain health insurers will seek methods to offset their additional expenses. This could mean more stringent requirements for prior authorizations on prescriptions, further limitations on covered medications, and increases in Part D premiums and copays.


These significant changes are expected to affect a large majority of Medicare beneficiaries. With AEP approaching, it is recommended that beneficiaries meet with licensed professionals to review their plans and understand how these changes will impact them.

Schedule your free review with one of our agents to find out what these changes mean for you.

Brian Faraci, Director of Operations, The Financial Guys Insurance Agency

“Securities offered through Peak Brokerage Services, LLC. Member FINRA /SIPC , Advisory services offered through Independent Solutions Wealth Management LLC., an SEC Registered Investment Adviser.

The Financial Guys and Independent Solutions Wealth Management LLC. are not affiliates of Peak Brokerage Services, LLC.”

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