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Medicare Updates for 2025

Each year, Medicare undergoes important changes that can affect your health coverage and costs. Staying informed about these updates is crucial to making sure you have the right coverage and that you’re not caught off guard by new costs or benefits. Pathway is here to guide you through the significant Medicare updates for 2025 and help you make the most informed decisions for your healthcare.

Key Changes to Medicare for 2025

$2,000 Cap on Out-of-Pocket Costs for Prescription Drugs

Starting in 2025, Medicare Part D will introduce a $2,000 annual cap on out-of-pocket expenses for prescription medications, providing much-needed financial relief to beneficiaries with high medication costs.

Elimination of the Coverage Gap (Donut Hole)

Medicare Part D will eliminate the coverage gap in 2025. After meeting your deductible, you’ll only pay a standard coinsurance rate, and once you reach the $2,000 cap, catastrophic coverage will kick in, drastically reducing your prescription drug costs.

New Discounts on Brand-Name Drugs

A new manufacturer discount program will provide discounts on brand-name medications—10% during the initial coverage phase and 20% during catastrophic coverage—helping to make essential prescriptions more affordable.

Part B Premium and Deductible Changes

In 2025, the standard Medicare Part B premium is expected to rise to $179.80 per month. Additionally, the annual Part B deductible will be $245, up from $240 in 2024.

Medicare Advantage Mid-Year Notifications

Medicare Advantage plans will now be required to send beneficiaries mid-year updates on unused supplemental benefits, such as dental, vision, or hearing services. This ensures that plan holders are fully informed about what benefits they’re eligible to use.

New Regulations on Medicare Sales Practices

In 2025, stricter regulations will limit sales incentives for brokers selling Medicare Advantage, Medigap, and Part D plans. These measures are designed to ensure beneficiaries receive unbiased advice when selecting their coverage.

With these changes on the horizon, it’s essential to review your Medicare plan during open enrollment to ensure it continues to meet your needs. Pathway is here to help you navigate these updates and find the plan that best supports your health and financial well-being.

Connect with a Medicare Specialist

Set up a time that works for you to speak with a knowledgeable Pathway Medicare Specialist. We’re here to answer your questions and guide you toward the right coverage.

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