2025 is just days away, and with it will bring a slew of changes for Social Security and those on Medicare. We got a glimpse about some of the changes earlier this year, but updates to Parts A and B came out a little later. Below, we’ll break down some of the most meaningful changes you can expect to see for Medicare in 2025.
The Social Security Administration determines the costs of what the Medicare will be and raise or lower plan premiums accordingly. We expect to hear more details in October, following the 2025 COLA increase announcement.
We’ll continue to provide updates to Medicare plan changes as more details are released, but below is what we know to expect to see in 2025. For more, don’t miss how to apply for Social Security Disability Insurance and four ways you can lose your Social Security benefits.
Changes to Medicare Part A
Part A helps pay for inpatient care you get in hospitals, critical access hospitals and skilled nursing facilities. Almost 99% of Medicare beneficiaries get Part A for free because they paid Medicare taxes while working, according to the Centers for Medicare & Medicaid Services.
The adjustment that will see the biggest increase in 2025 is the inpatient hospital deductible, which will see a boost of $44 to $1,676 versus $1,632 in 2024. All other deductibles and coinsurances for Part A will only see modest increases.
Part A deductible and coinsurance amounts: 2024 vs. 2025
Inpatient hospital deductible | $1,632 | $1,676 |
---|---|---|
Daily hospital coinsurance for 61st-90th day | $408 | $419 |
Daily hospital coinsurance for lifetime reserve days | $816 | $838 |
Skilled nursing facility daily coinsurance (days 21-100) | $204.00 | $209.50 |
Changes to Medicare Part B
Part B covers medical services like doctors’ services and outpatient care. Part B is optional, and for 2024, Part B’s premium is $174.70 per month. As expected, premiums are increasing for 2025.
Beneficiaries filing as an individual with a modified adjustment gross income of $106,000 or beneficiaries with a gross income of $212,000 or less can expect their total monthly premium amount to be $185 this year. This does not include an income-related month adjustment amount, but beneficiaries making more will see this adjustment added. The full Part B coverage chart can be found below.
Full Part B coverage
Beneficiaries filing as individuals w/ gross income: | Beneficiaries filing jointly w/ gross income: | Income-related monthly adjustment amount | Total monthly premium amount |
---|---|---|---|
Less than or equal to $106,000 | Less than or equal to $212,000 | $0.00 | $185 |
Greater than $106,000 and less than or equal to $133,000 | Greater than $212,000 and less than or equal to $266,000 | $74 | $259 |
Greater than $133,000 and less than or equal to $167,000 | Greater than $266,000 and less than or equal to $334,000 | $185 | $370 |
Greater than $167,000 and less than or equal to $200,000 | Greater than $334,000 and less than or equal to $400,000 | $295.90 | $480.90 |
Greater than $200,000 and less than $500,000 | Greater than $400,000 and less than $750,000 | $406.90 | $591.90 |
Greater than or equal to $500,000 | Greater than or equal to $750,000 | $443.90 | $628.90 |
For the full rundown of Medicare Plan Part B adjustments, you can visit the Centers for Medicare & Medicaid Services’ 2025 fact sheet.
Changes to Medicare Part C
Medicare Advantage, or Medicare Part C, will also be receiving some updates. Part C plans come from private companies and can offer extra coverage, such as vision, hearing, dental and health and wellness programs.
Pricing for this alternative varies by the plan you choose. An upcoming change to Part C will remind enrollees what they could be potentially leaving on the table. For Medicare Advantage participants, starting in 2025, a midyear notification will inform you of any unused benefits that are available that you can take advantage of.
This will both remind you to use your benefits and reassess whether you need the specific plan they signed up for. When reenrollment time comes around, you will be able to make a more informed decision about whether you should stay with your current plan or switch to a new one.
Big Changes to Medicare Part D coming in 2025
Part D can help cover the costs of prescription drugs. So, what’s new with Medicare Part D for 2025? The Inflation Reduction Act will bring a host of changes to Part D plans this year. We’ll break it down.
Base premium increase expected
According to the CMS, the Part D base beneficiary premium will increase by $2.08, or 6%, from $34.70 to $36.78. The IRA adds in a 6% cap to the base Part D plans, but actual premiums may vary. CMS said it will release preliminary Part D premium averages later this summer.
New $2,000 out-of-pocket maximums for medications
A big 2025 change for Plan D enrollees will be the $2,000 out-of-pocket maximum per year for medications. This change could have some major benefits for enrollees who have expensive medications they need to take on a monthly basis.
Note that medications covered under Medicare Part B will not count toward this maximum, as these are typically provided by a doctor or practitioner at a facility.
The Coverage Gap (doughnut hole) will be gone in 2025
In 2024, there were four stages of coverage. Deductible, Initial, Coverage Gap (known as the doughnut hole) and Catastrophic. The Coverage Gap is a temporary limit on what the drug plan will cover for drug costs. In 2025, Medicare will eliminate the donut hole coverage gap, further simplifying coverage. Now, with the new out-of-pocket max of $2,000, Plan D participants will need to pay their deductible (up to $590), then make copayments until they reach the new maximum, getting them to the next level of coverage faster than previous years.
New medication payment plan options
A new payment plan option will enable people to pay for their medications over the year in the form of a payment plan instead of upfront. The new plan allows someone to opt-in to this payment plan and spread the payments out for the remainder of the months in the year, and payments may not exceed a certain amount. The payment plan is opt-in only.
For more, be sure to check out the Social Security Payment schedule and the Social Security and SSDI cheat sheet.
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