In 2024, Medicare announced updated cost-sharing amounts and implemented several changes aimed at enhancing access to healthcare services for its beneficiaries.
Here are some of the most significant changes we saw across the board in 2024 and a glimpse into next year:
Medicare Part A (Hospital Insurance)
- Premium Adjustments: Part A remains premium-free for most people. If you must purchase Part A, you’ll pay either $278 or $505 per month.
In 2025, these monthly premiums increase to $285 and $518.
- Deductible and Copayment Adjustments:
Part A cost-sharing amounts are as follows:
- $1,632 Deductible per benefit period
- $408 Daily hospital coinsurance for 61st-90th day
- $816 Daily hospital coinsurance for lifetime reserve days
- $204 Skilled nursing facility daily coinsurance (days 21-100)
In 2025, Part A cost-sharing will increase to these amounts:
- $1,676 Deductible per benefit period
- $419 Daily hospital coinsurance for 61st-90th day
- $838 Daily hospital coinsurance for lifetime reserve days
- $209.50 Skilled nursing facility daily coinsurance (days 21-100)
Medicare Part B (Medical Insurance)
- Premium and Deductible Adjustments: The standard monthly premium for Part B increased to $174.70 and the annual deductible is $240.
In 2025, the standard Part B premium is $185, and the deductible is $257.
These increases mirror increase rates from last year.
Medicare Advantage (Part C)
- Enhanced Behavioral Health Access: Medicare Advantage plans are required to include more clinical psychologists and licensed clinical social workers in their networks, aiming to improve access to behavioral health services.
- Telehealth: Plans must develop procedures to offer digital health education to members, enhancing access to telehealth services. This year, members can receive Telehealth services without geographic restrictions.
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This year, members can receive Telehealth services without geographic restrictions. However, in 2025, Telehealth services may only be covered in rural or underserved areas.
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- Health Equity Initiatives: Provider directories are required to include information on providers’ cultural and linguistic capabilities to better serve diverse populations.
Medicare Part D (Prescription Drug Coverage)
- Elimination of Catastrophic Phase Coinsurance: Medicare beneficiaries are no longer required to pay the 5% coinsurance during the catastrophic phase of Part D coverage.
- In year 2025, the Coverage Gap (Donut Hole) will be eliminated, and out-of-pocket expenses will be capped at $2,000 for all Medicare beneficiaries, providing financial relief to those with high prescription drug costs.
- Expanded Low-Income Subsidy (LIS): Individuals who previously qualified for partial LIS now receive the full subsidy, improving access to affordable prescription drug coverage for approximately 300,000 low-income individuals with Medicare.
Medicare Supplement (Medigap)
- Deductible Adjustments for High Deductible Plans: Plans F, G, and J offer high deductible plans. This year, the deductible was set at $2,800, and in 2025 it will rise to $2,870.
- Out-of-Pocket Limit Adjustments: Plans K and L have out-of-pocket limits of $7,060 and $3,530. Next year the limit for Plan K is $7,220 and $3,610 for Plan L.
- Added Guarantee Issue Rights: Several states added a Birthday Rule this year, which is a Guaranteed Issue Right that allows Medigap enrollees to make plan changes without going through medical underwriting.
These changes reflect Medicare’s ongoing efforts to enhance healthcare affordability, access, and quality for its beneficiaries. Beneficiaries are encouraged to continually review updates and consider how they may impact their healthcare choices and expenses.
If you would like to review specific plan options, our licensed agents here at AMAC are always happy to assist you. They are licensed with top-rated insurers throughout the country.
Call 1-855-611-4856 to speak with one today or request a quote below!