2025 Medicare Changes: What You Need to Know

2025 Medicare Changes: What You Need to Know

In 2025, Medicare will eliminate the Part D coverage gap, cap out-of-pocket prescription costs at $2,000, and offer a payment plan. Some Georgia Medicare Advantage plans will not renew, allowing members to switch plans or join Medigap without underwriting. The Part B premium will rise to $185/month, and fraud risks are expected to increase. Tune in to this episode of A Wiser Retirement® Podcast as Casey Smith and Logan Steele, from Steele Choice Insurance, dive into the details of these upcoming Medicare changes.

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Summary

1. Inflation Reduction Act (IRA) Changes:

  • The Part D coverage gap (“doughnut hole”) will be eliminated, meaning more consistent coverage for prescription drugs.
  • The maximum out-of-pocket costs for covered prescription drugs under Part D will be reduced to $2,000 (down from $5,000).
  • Medicare beneficiaries will have the option to spread out their prescription costs through a Medicare Prescription Payment Plan.
  • Employer group coverage may no longer count as creditable drug coverage starting in 2025, potentially impacting retirees and those on employer-sponsored plans.

2. Medicare Advantage Plan Changes in Georgia:

  • Several popular Medicare Advantage plans in Georgia will not renew in 2025.
  • Affected members will have additional time to enroll in new plans.
  • There will be an option to switch to a Medicare Supplemental (Medigap) plan without undergoing underwriting.

3. Standard Part B Premium Increase:

  • The standard Part B premium is estimated to increase to $185/month.

4. Increased Fraud and Solicitation Risks:

  • Due to these changes, fraud is expected to rise significantly in the next few months, with carriers predicting a particularly high year for fraud activity.

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