Medicare Changes to Watch for in 2025

Key updates taking effect this year

Prescription drug cap:

 Starting January 1, 2025, Medicare Part D enrollees can’t spend more than $2,000 in out‑of‑pocket costs for covered medications—eliminating the “donut hole” entirely. Enrollees may also opt to spread drug expense payments monthly through the voluntary Medicare Prescription Payment Plan Centers for Medicare & Medicaid Services+15PAN Foundation+15National Council on Aging+15.

Part B premium & deductible increases: 

The standard Part B premium rises to $185/month (up from $174.70 in 2024), with an annual deductible of $257 medicareresources.org+5Centers for Medicare & Medicaid Services+5Wikipedia+5.

Medicare Advantage caps & benefits: 

Average MA premiums edge down to around $17/month, but the out‑of‑pocket maximum rises up to $9,350 in-network. Plans may reduce supplemental benefits or adjust co-pay structures medicareresources.org+1National Council on Aging+1.

Mid‑year unused benefits notice: 

MA plans must begin sending Personalized Mid‑Year Notifications in July to remind enrollees of unused supplemental benefits (like dental, vision, fitness)—including costs and access instructions .

Broker compensation reforms: 

CMS will eliminate variable sales incentives for Medicare Advantage and Part D agents and brokers, shifting to fixed compensation caps with an approximate $100 premium bump for new enrollments in 2025 .