Medicare Changes that Can Impact Your Health Care in 2025

A new year means new changes to your Medicare coverage. In 2025, there are some reasons to rejoice. Part D out-of-pocket drug costs will be capped at a dollar amount lower than ever before, and caregivers will have access to more training opportunities. There’s some bad news in the mix, too, though, like a reduction in telehealth coverage and an (admittedly predictable) increase in Part B premiums and deductibles. 

Let’s review what you can expect with the turn of the calendar year.

Medicare Changes to Expect in 2025

1. Lower cap on Part D out-of-pocket drug costs.

If you have Part D coverage, your out-of-pocket costs for prescription medications will be capped at an incredibly low $2,000 per year. That $2,000 doesn’t necessarily have to come out of your own pocket, either. If you’re on the Extra Help program and receive low-income subsidies on your medications, those subsidies will count towards the $2,000 max, too. 

In future years this number could go up, as the cap will be indexed for inflation.

NOTE: The $2,000 cap applies only to medications covered by Part D. Part B treatments, like vaccinations, injections at the doctor’s office and some outpatient prescriptions aren’t subject to the $2,000 limit.

2. Pay for your prescription medications with monthly payment plans.

Even with the Part D cap, $2,000 can be a lot to afford when you’re on a budget. When we’re talking about prescription drugs, it’s not an expense you want to put off just because you can’t pay the full amount due in a single month. 

Fortunately, in 2025 there’s a new Medicare provision that allows you to spread those payments out. Enrolling won’t cost you extra or save you any money, but it will allow you to pay for your prescription drugs on a monthly plan billed by your plan provider.

3. Part B premium increases.

Part B premiums and deductibles are increasing in 2025. This isn’t terribly out-of-line. Most years, premiums do go up. This year, Part B premiums are $185 per month (a 5.90% increase over 2024), and deductibles are $257 (a 7.08% year-over-year increase.)

4. Additional caregiver training.

If your health is such that you have a caregiver, it’s highly likely that they are a family member or friend – not necessarily a trained medical professional. In 2025, those caregivers can now receive training from your health care provider – albeit at a cost. You’ll be billed 20% of the Medicare-approved amount for the training, and your Part B premiums will still apply. It’s also important to note that you are not required to be present at the training, which may be a relief to some or a cause for concern to others.  

NOTE: There is also a new pilot program for dementia patients and their caregivers called “Guiding an Improved Dementia Experience Model”. You’ll only qualify for this particular program if your practitioner happens to be participating in it.

5. Reduction in telehealth access.

During the pandemic, everything from state legislatures to Medicare policy made it easier to access telehealth services. We are now seeing that accessibility scaled back across sectors. Starting in 2025, the situations where Medicare will cover telehealth services will be much more restricted. 

If you live in a rural area, you will still be able to get telehealth services – but only if you’re inside a doctor’s office or other medical facility within a rural community. It won’t necessarily be as easy as video calling a specialist from the comfort of your own living room. 

It is important to note, though, that regardless of where you live, you’ll still be able to access a few select services remotely, even in your own home: 

• Mental health and behavioral health services. 
• Substance use disorder services.
• Diagnosis, evaluation or treatment of an acute stroke.
• End-Stage Renal Disease dialysis visits on a monthly basis.
• Diabetes self-management training.
• Medical nutrition therapy. 

For everything else, though, you’re going to have to start going into a physical doctor’s office.

6. Expect a Medicare Advantage notice halfway through the year.

Medicare Advantage plans often come with auxiliary benefits, like dental and vision. But as it turns out, a lot of these benefits tend to go unused. To ensure people are aware of and using the benefits they’re paying for, there is a new requirement that Medicare Advantage plans send out a notice halfway through the year, letting you know what your benefits are, which ones you’ve claimed to date, and which ones you can still use before the end of December.

Pittsburgh-based writer Brynne Conroy is the founder of the Femme Frugality blog and the author of “The Feminist Financial Handbook.” She is a regular contributor to The Penny Hoarder.