Remember the following six adjustments to Medicare scheduled for 2025:
Remember the following six adjustments to Medicare scheduled for 2025:
We're nearly at the end of the Medicare subscription renewal period, which happens once a year and offers individuals the chance to select a new plan for 2025. If you haven't reviewed your healthcare coverage yet, you still have time. The renewal period lasts until Dec. 7, so you wouldn't want to wait too long.
Getting a grasp on the significant alterations coming to Medicare in 2025 will make it easier for you to choose a plan that suits you best. Some of these changes may not directly affect you now, but it's worth taking notice of them as we approach the new year.
1. $2,000 cap on yearly prescription drug cost expenditures
The most significant change to Medicare coming in 2025 is the introduction of a $2,000 cap on yearly prescription drug costs. This cap encompasses both the money you spend on your medications and the contributions made on your behalf by anyone else, including Medicare's Extra Help program. Once you reach the $2,000 limit, Medicare won't charge you any additional copays for prescription drug costs for the remaining part of 2025.
2. New prescription drug payment scheme
Alongside this, Medicare is introducing a new prescription drug payment scheme aimed at helping you distribute your costs evenly throughout the year. Although this doesn't decrease the overall amount you owe, it is an optional feature that you must opt-in for if you wish to participate.
Those opting into this scheme will not need to pay anything at the pharmacy. Instead, their Part D plan provider will send them an invoice for their prescription drug costs accumulated so far during the year. This could prove beneficial if you have high prescription costs early in the year. However, it may not provide much assistance if you incur most of your costs later in the year. You can discover more about this payment plan option on Medicare's website.
3. Tightened restrictions on remote medical services
Currently, Medicare beneficiaries can avail of telehealth services from any location up till the end of 2024. But beginning in 2025, these services will only be covered if you're in an office or medical facility situated in a rural area.
There are a few exceptions to this rule, such as:
- Monthly consultations for patients with terminal kidney disease undergoing home dialysis
- Services for diagnosing, evaluating, or treating symptoms of acute strokes regardless of location
- Services to treat substance use disorders or co-occurring mental health disorders or for diagnosing, evaluating, or treating mental health disorders
- Behavioral health services
- Diabetes self-management training
- Nutritional therapy
If you meet the criteria for any of these exceptions, telehealth services remain covered, regardless of your location. However, you still need to pay your Part B deductible and 20% of the Medicare-approved amount.
4. Additional screenings at annual wellness visits
An annual wellness visit, which assesses your current health and provides advice for managing existing conditions, is mandatory for all Medicare beneficiaries. Starting in 2025, this visit will include assessments for cognitive decline and evaluations for substance use disorders, if necessary.
5. New training resources for caregivers
If the healthcare provider deems that caregiver training is crucial for your treatment plan, your caregiver can participate in individual or group training sessions covered by your Medicare plan in 2025. You don't have to be present during these sessions, but they must focus on your health goals and relevant skills for your care.
Medicare is also launching a new pilot program for individuals with dementia and their family members and caregivers. You can inquire with your healthcare provider to determine if they are participating in this program.
6. New benefit program for U.S. Postal Service workers
From 2025, U.S. Postal Service employees will no longer receive benefits through the Federal Employee Health Benefits (FEHB) program. Instead, they will be covered under their own U.S. Postal Service Health Benefits (PSHB) program. You can find more information about this change on the U.S. Office of Personnel Management website.
While this change may not affect most people, keep an eye on the others as we move into 2025 even if they don't seem relevant at the moment. For instance, caregiver training may not seem important now, but if you experience a major injury or illness in 2025, this could become crucial. Keep these key modifications in mind as we welcome the new year.
As you plan for retirement, it's essential to consider how these Medicare changes could impact your finances. The $2,000 cap on yearly prescription drug costs, for example, could significantly reduce your out-of-pocket expenses for medication. (finance, retirement, money)
Moreover, the new prescription drug payment scheme allows you to distribute your costs evenly throughout the year, which might be beneficial for those with high prescription costs at the beginning of the year. (finance, retirement, money)