It’s that time of year for Medicare, the annual open enrollment. For the 2025 plan year, open enrollment will run from October 15 to December 7, 2024. Clients often find navigating the ever-changing world of Medicare a challenge. This year is no different with impacts from the Inflation Reduction Act. As we look ahead to 2025, several significant changes are on the horizon that can impact your benefits.
Although not a complete list; here is an overview of some of the changes and what to expect:
Expansion of Benefits
One of the most notable changes is the expansion of Medicare benefits. Starting in 2025, Medicare will begin to cover additional services, particularly in preventive care and mental health services. This will include.
- Dental, Vision and Hearing: Services that have long been a gap in Medicare coverage will provide access to regular check-ups and necessary treatments without incurring substantial out-of-pocket costs.
- Mental Health Support: Medicare will cover expanded mental health care services with access to more resources and intensive outpatient programs. Telehealth services will also be expanded for in-home mental and behavioral care.
Prescription Drug Pricing Reform
- Capping out-of-pocket costs: One of the most notable in 2025, is an out-of-pocket cap on prescription drugs for Medicare Part D beneficiaries of $2,000 and the elimination of the donut hole. This will provide significant cost savings for those with high medication expenses and a welcomed change.
Changes to Medicare Advantage Plans
Medicare Advantage plans have grown in popularity over the past several years and we will see some enhancements.
- Increased Transparency: The Centers for Medicare and Medicaid Services (CMS) will introduce new regulations to provide clearer information about coverage options, including costs and benefits.
- Enhanced Plan Offerings: Many plans will offer addition al benefits such as wellness programs and personalized health support making them a more attractive option.
More Resources for Caregivers
- Medicare covers additional caregiver support, like training that helps your caregiver provide better care and relief when caring for family members in Hospice.
- A new pilot program for dementia patients will aim to provide more support for their caregivers.
Changes to Telehealth Coverage
- Currently you can get telehealth services at any location in the U.S., including your home. After December 31, 2024, you must be in an office or medical facility located in a rural area for most telehealth services. Mental and Behavioral health services will still be available in your home.
If you are starting Medicare or currently on Medicare, open enrollment is a good time to review your current coverage, the upcoming changes and how they may affect you and your care. We recommend connecting with a Medicare specialist to review your coverage and personal circumstances and how the 2025 changes may affect your care. If you have any questions about these changes and how they may affect your long term goals, please reach out to the VLP team.