Introduction of a $2,000 Cap on Part D Out-of-Pocket Costs A major change is the implementation of a $2,000 annual cap on out-of-pocket expenses for Medicare Part D prescription drug plans. This aims to alleviate the financial burden of high-cost medications for beneficiaries.
Elimination of the "Donut Hole" Coverage Gap The notorious "donut hole" in Medicare Part D coverage will be eliminated. Previously, beneficiaries faced a coverage gap after reaching a certain spending threshold, leading to higher out-of-pocket costs.
Adjustments to Medicare Part A and Part B Costs Beneficiaries should anticipate increases in premiums, deductibles, and coinsurance for Medicare Parts A and B. These adjustments reflect projected price changes and assumed utilization increases consistent with historical experience.
Changes in Medicare Advantage Plan Benefits Some Medicare Advantage plans may reduce certain benefits due to adjustments in government payments. However, the majority will continue to offer supplemental benefits, including dental, hearing, and vision care.
Enhanced Coverage for Specific Health Services Medicare will expand coverage to include additional behavioral health services, cardiovascular risk assessments, and dental care associated with specific chronic conditions.
Mid-Year Notifications for Unused Supplemental Benefits Starting in July 2025, Medicare Advantage plans are required to send personalized mid-year notifications to enrollees, detailing any unused supplemental benefits.