Major Medicare Changes in 2025: What You Need to Know

What’s Happening to Medicare in 2025?

There are several upcoming Medicare changes in 2025 to be aware of. These changes could affect your Medicare coverage or that of someone you love. So, here’s what you need to know.

Expanded Telehealth Services

One of the biggest upcoming changes to Medicare is increased access to telehealth services under the 2025 Medicare Physician Fee Schedule Proposed Rule.

Coverage for telehealth services will be expanded to include audio-only communications, which could make care more accessible for seniors who do not have video technology in their homes or who don’t know how to use it.

This rule will also allow physicians to provide “direct supervision” via telehealth services, and allow physicians to continue providing telehealth services from home under their office address.

Over the past few years, many providers have started offering medical services using telehealth platforms. According to the US Department of Health and Human Services, 26.8% of Medicare beneficiaries used some form of telehealth care in 2022.

This new rule makes telehealth services more accessible for both Medicare beneficiaries and their providers.

For seniors with limited mobility or those living in remote rural areas, telehealth makes it much easier to get regular medical care. Telehealth has been a particularly popular solution for mental health services, allowing patients to get services like therapy and psychiatric care without having to travel.

Adjustments to Part B Premiums and Deductibles

A key change to be aware of is the adjustment to Medicare Part B premiums and deductibles, which could impact your out-of-pocket costs for services like medical exams, testing, and vaccines.

The Centers for Medicare and Medicaid Services (CMS) has officially announced the Part B premium and deductible amounts for 2025. Take a look:

• Part B Premiums: The standard monthly premium for Part B is $185.00 in 2025, up from $174.70 in 2024.
• Deductibles: The annual deductible for Part B services has increased to $257 in 2025, up from $240 in 2024.

Additionally, Medicare beneficiaries with higher incomes will pay more, through an income-related monthly adjustment amount (IRMAA). The income thresholds for IRMAA will be adjusted for inflation, and these premiums are expected to rise in line with the new cost-of-living adjustments.

Make sure to review the official announcements from CMS for detailed updates, especially if your income is above the threshold for IRMAA, as you may see significant changes in the premium rates.

Changes to Medicare Advantage Part C Plans

If you have a Medicare Advantage plan, your coverage could change in 2025 as well. Since Medicare Advantage plans are run by private insurance companies, they each have different coverage levels and pricing.

You will need to contact your insurer directly or contact your broker to see how your plan is expected to change next year. You can switch plans during the annual open enrollment period from October 15th to December 7th, and many Medicare Advantage plan beneficiaries also have the opportunity to make a one time change during the Medicare Advantage Open Enrollment from January 1st to March 31st. Some beneficiaries opt to switch plans if their coverage changes significantly.

According to the Centers for Medicare and Medicaid Services, the average monthly premium for Medicare Advantage plans is projected to decrease from $18.73 in 2024 to $17 in 2025.

Prescription Drug Coverage Updates (Part D)

Medicare 2025 includes major changes to Part D prescription drug plans due to the Inflation Reduction Act. Notably, this law closes the Part D “donut hole,” which is a coverage gap that limited Part D drug costs.

Starting in 2025, there will be three phases of Part D prescription drug coverage: deductible, initial, and catastrophic coverage. If your out-of-pocket drug costs reach $2,000, you will enter catastrophic coverage and won’t need to pay for any covered drugs for the rest of the year.

Other notable Medicare Part D changes in 2025 include the introduction of the Medicare prescription payment plan, which helps Medicare beneficiaries spread their prescription drug expenses out throughout the year. This option will be available for all Medicare drug plans, including both Part D plans and Medicare Advantage plans with drug coverage.

While this payment plan isn’t required, it could be particularly helpful for beneficiaries with high drug deductibles.