If you’re enrolled in Medicare and wondering if your current coverage is right for your future needs, now is the time to consider changing your plan or switching to another. Medicare’s annual enrollment period, commonly called “open enrollment,” runs from October 15 to December 7. This is the window during which you can maximize your Medicare coverage for the following calendar year.

Read on to learn about changes to Medicare costs and benefits for 2025, as well as resources where you can access detailed information specific to your region.

An annual limit of $2,000 for medications to be paid for

In 2024, all Medicare members, regardless of their insurance provider, had a maximum Part D amount to pay between $3,300 and $3,800 – for 2025, this amount will be capped at $2,000 , which is lower than ever. Additionally, Part D’s controversial “donut hole” – a coverage gap between initial copay and coinsurance coverage and full catastrophe coverage – will, after being gradually eroded after the Affordable Care Act was enacted in 2010, only to be eliminated altogether.

Under the new system, the standard annual Part D deductible will increase from $545 to $590. Once that limit is reached, you’ll pay 25% of the drug cost until your out-of-pocket expenses reach $2,000, after which you’ll immediately have catastrophic coverage without that precarious “donut hole” and no longer have to extra money. -out-of-pocket costs for prescriptions during that calendar year. THE Inflation Reduction Act also requires a Part D manufacturer rebate program that covers 75% of the cost of applicable drugs to close the previous coverage gap beginning January 1.

Some premiums should decrease

Some Medicare beneficiaries, including those who received expensive brand-name drugs, will begin saving money on health care costs next year thanks to the new $2,000 drug cap described above. But some plans may simultaneously adjust their premiums, formularies (the lists of covered prescription drugs), copayments, or deductibles in response to the resulting increase in costs.

Fortunately, any potential increase in Plan D premiums will be capped at $35 per month thanks to a new program, the Part D Premium Stabilization Demonstration. And, overall, the average Part D premium is expected to decrease by $7.45 to $46.50 in 2025, according to the Centers for Medicare and Medicaid Services (CMS). CMS also predicts that Medicare Advantage premiums will be lower in 2025, dropping from an average of $18.23 per month to $17.00. More than 80% of Medicare Advantage enrollees will have the same or lower premium in 2025 if they stay on the same plan, and about 60% are expected to have a zero-dollar premium.

Medicare Prescription Payment Plan

Another new program for 2025 is the optional program Medicare Prescription Payment Plan. As the name suggests, this allows enrollees to spread prescription costs over the plan year rather than paying them all at once at the pharmacy. Beneficiaries who elect the Medicare prescription payment plan will receive a monthly bill for prescriptions from their Medicare Advantage plan or standalone Part D plan.

Although there is no fee to participate in the Medicare Prescription Payment Plan, the payment amount may fluctuate each month until the new maximum of $2,000 is reached.

Premiums and deductibles part B 2025

Whether you’re enrolled in Original Medicare or Medicare Advantage, your plan will include Medicare Part B, covering outpatient services such as doctor visits, outpatient surgeries, and medical devices. Each year, Part B premiums and deductibles change to reflect adjustments related to inflation and rising health care costs. In 2025, these are expected to rise from $174.70 to around $185 next year. Although all Medicare enrollees pay Part B costs, some government cost reduction programs and programs through Medicare Advantage plans may reduce or even eliminate the Part B premium for low-income beneficiaries.

Medicare Information Resources

During the open enrollment period, Medicare-eligible individuals can access information to compare health and drug coverage options on healthinsurance.gov and his Health Insurance Plan Searchwhere you can compare the plans available in your area by entering your zip code. Medicare beneficiaries should have already received the latest official report Medicare and you manual by mail and this can also be downloaded, in multiple languages ​​and formats, at any time. Additionally, you can call (800) MEDICARE (633-4227) or contact California Health Insurance Advisory and Advocacy Program – (800) 434-0222 – for California-specific Medicare advice and finding services in your county.

-Paul Rogers