What is the new Medicare rule for 2025?

Asked by: Shaina White II  |  Last update: September 12, 2025
Score: 5/5 (34 votes)

Beginning January 1, 2025, people with Part D plans through traditional Medicare and Medicare Advantage plans with prescription drug coverage won't pay more than $2,000 over the calendar year in out-of-pocket costs for their prescription medications.

What big changes are coming to Medicare in 2025?

Medicare is a federal health insurance program for older adults ages 65 and older. Open enrollment for 2025 Medicare plans runs through December 7. Some major changes in 2025 include a new $2,000 out-of-pocket max under Part D, eliminating the plan's “donut hole” coverage gap, and fewer Medicare Advantage plans.

What is the deductible for Medicare in 2025 for seniors?

The annual deductible for all Medicare Part B enrollees in 2025 will be $257, an increase of $17 from the 2024 deductible of $240.

What is the projected Medicare Part B premium for 2025?

The Centers for Medicare and Medicaid Services (CMS) has announced the new standard Medicare Part B monthly premium for 2025 is $185.00.

What is the donut hole for 2025?

Starting in 2025, Medicare no longer has a 'donut hole,' or coverage gap. In prior years, you paid up to 25% out of pocket for covered medications in the donut hole phase. Starting in 2025, once you reach the annual out-of-pocket cap ($2,000 in 2025), you're done paying out of pocket for the year.

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How do I avoid the Medicare donut hole?

Discuss lower-cost drug alternatives with your healthcare professionals. Seek out discounts on medications. Choose generic drugs over brand-name drugs. Opt for in-network pharmacies only.

How much will Medicare Part D cost in 2025?

The average estimated monthly Part D plan premium in 2025 is $46.50. Other factors can affect the cost of Part D including monthly premium, yearly deductible and copayments. High-income earners may pay a surcharge known as the “income-related monthly adjustment amount” (IRMAA).

Does everyone pay $170 for Medicare Part B?

Most people pay no premiums for Part A. For Medicare Part B in 2025, most beneficiaries will pay $185 per month. Certain factors may require you to pay more or less than the standard Medicare Part B premium in 2025.

What are the changes to social security in 2025?

In 2025, all beneficiaries will see a 2.5% increase to their Social Security benefit checks, thanks to an annual cost-of-living adjustment. Of note, the 2024 increase was 3.2%. This year's COLA is the lowest increase beneficiaries have seen since a 1.3% increase in 2021, reflecting a decrease in the pace of inflation.

How do you qualify for $144 back from Medicare?

To be eligible for the Medicare Part B Giveback Benefit, you must:
  1. Be enrolled Original Medicare (Parts A and B)
  2. Pay your own Part B premium.
  3. Live in the service area of a plan that offers a Part B giveback.

What year will Medicare end?

A key trust fund underpinning the massive Medicare program has a new insolvency date: 2036, according to a new report from the Medicare trustees.

What income level triggers higher Medicare premiums?

If you file your taxes as "married, filing jointly" and your MAGI is greater than $212,000, you'll pay higher premiums for your Part B and Medicare prescription drug coverage. If you file your taxes using a different status, and your MAGI is greater than $106,000, you'll pay higher premiums.

What is the taxable income limit for Social Security in 2025?

What is the current maximum amount of taxable earnings for Social Security? In 2025, the maximum amount of earnings on which you must pay Social Security tax is $176,100. We raise this amount yearly to keep pace with increases in average wages. There is no maximum earnings amount for Medicare tax.

Why are people dropping Medicare Advantage plans?

Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.

What is the income limit for extra help in 2025?

Extra Help eligibility

If your monthly income is up to $1,976 in 2025 ($2,664 for couples) and your assets are below specified limits, you may be eligible for Extra Help (see the Extra Help income and asset limit chart for details).

What will happen to Medicare in 2026?

The Contract Year (CY) 2026 MA and Part D proposed rule aims to hold MA and Part D plans more accountable for delivering high-quality coverage so that people with Medicare are connected to the care they need when they need it.

At what age is Social Security no longer taxed?

Social Security income can be taxable no matter how old you are. It all depends on whether your total combined income exceeds a certain level set for your filing status. You may have heard that Social Security income is not taxed after age 70; this is false.

How do I get the $16728 Social Security bonus?

Specifically, a rumored $16,728 bonus that had people wondering if it was true or not in 2024? Sadly, there's no real “bonus” that retirees who receive Social Security can collect.

When my husband dies, do I get his Social Security and mine?

You cannot claim your deceased spouse's benefits in addition to your own retirement benefits. Social Security only will pay one—survivor or retirement.

How much will Medicare cost in 2025 for seniors?

The standard monthly premium for Medicare Part B enrollees will be $185.00 for 2025, an increase of $10.30 from $174.70 in 2024. The annual deductible for all Medicare Part B beneficiaries will be $257 in 2025, an increase of $17 from the annual deductible of $240 in 2024.

Why is Social Security no longer paying Medicare Part B?

There could be several reasons why Social Security stopped withholding your Medicare Part B premium. One common reason is that your income has exceeded the threshold for premium assistance. Another reason could be that there was a mistake or error in your records.

Is Medicare free at age 65 for seniors?

People age 65 or older, who are citizens or permanent residents of the United States, are eligible for Medicare Part A. You're eligible for Part A at no cost at age 65 if 1 of the following applies: You receive or are eligible to receive benefits from Social Security or the Railroad Retirement Board (RRB).

Why do people say not to get a Medicare Advantage plan?

Disadvantages of Medicare Advantage plans can include difficulty switching out of the plans later, restrictions on care access, limited provider networks, and limitations on extra benefits.

What is the Medicare final rule for 2025?

The Centers for Medicare & Medicaid Services Nov. 1 released its calendar year 2025 final rule for the physician fee schedule. The rule will cut the conversion factor by 2.8% to $32.35 in CY 2025 compared to $33.29 in CY 2024.

How much does Humana cost per month for seniors?

Premiums for Humana's plans start at $0 per month in addition to your Medicare Part B premium. In 2024, the standard part B premium amount is $174.70, but this number can go all the way up to $594 per month for high-earning seniors3.