Another year brings significant updates to Medicare, and 2025 is no exception.
From rising costs and expanded benefits to changes in Medicare Advantage and Prescription Drug Plans, understanding these updates is key to guiding your clients through their options.
As always, Medicare costs are changing in 2025.
Related: 2025 Medicare Parts A & B Premiums and Deductibles
In 2025, the standard Medicare Part B premium is $185, an increase of $10.30 from $174.70 in 2024.
The Part B deductible is also going up to $257 in 2025, a $17 increase from 2024.
Note: to easily show these costs to your clients, you can download our customizable 2025 Medicare Costs handout:
For about 8% of people with Medicare Part B that have a high income, their Part B premiums will range from $259-$628.90 per month.
Here are some quick Part A cost highlights for 2025:
Most people don't pay a monthly premium for Part A. For those that paid Medicare taxes for less than 30 quarters, the standard Part A premium is $518 in 2025 (a $13 increase from 2024). And for those that paid Medicare taxes for 30-39 quarters, the standard Part A premium is $285 in 2025 (a $7 increase from 2024).
Help your clients understand their 2025 Medicare costs with customizable and fillable Client Guide to Medicare Parts A & B.
Integrity has made serious investments in technology to help you produce more and serve your clients more efficiently.
We're so excited about the recent developments with MedicareCENTER and LeadCENTER, and we're excited to continue sharing new features and updates in 2025.
MedicareCENTER has had a ton of recent improvements.
Low Income Subsidy (LIS): Now, you have the option to indicate if your client is eligible for LIS assistance right in your Contact Profile. Plan options are then automatically filtered accordingly to reflect the LIS status.
Multi-pharmacy: You can now enter up to three pharmacies at once and compare prices for your clients!
Here’s what you need to know about the key changes to stand-alone Prescription Drug Plans (PDPs) in 2025 and how they might impact your clients.
The number of stand-alone Prescription Drug Plans (PDPs) is dropping by 26% in 2025, leaving 524 options nationwide, with at least 12 plans per state.
LIS recipients face an even sharper reduction, with just 115 premium-free "benchmark" plans available, varying from two to six options by state. Meanwhile, Medicare Advantage plans with drug coverage (MA-PDs) are expanding, offering more bundled options at lower costs.
The base Part D premium rises 6% in 2025 to $36.78.
While increases are capped under the Inflation Reduction Act, clients may see varying costs based on their plans, making it even more important that you help them compare options.
Full Low-Income Subsidy (LIS) benefits, extended in 2024 to all qualifying beneficiaries, remain in place for 2025, significantly lowering drug costs for eligible clients.
New Medicare drug price negotiations could lower costs, but many independent pharmacies may not stock these medications due to high upfront costs.
Clients relying on drugs like Eliquis, Jardiance, or Januvia may face limited availability, particularly in smaller pharmacies. Keep an eye on this as changes unfold.
Medicare Advantage continues to grow, with enrollment expected to exceed 36 million by 2025, representing 60% of the Medicare population.
While total plans are slightly down by 3%, with 5,218 options nationwide, the increase in enrollment highlights shifting beneficiary preferences.
Related: Medicare Advantage Highlights For the 2025CY AEP
The average Medicare Advantage premium will drop to $17.00 in 2025, with 87% of plans having premiums under $50 and 58% offering $0 premiums.
However, $0 premium/$0 drug deductible plans will decline from 39% in 2024 to 22% in 2025.
Starting in 2025, Medicare Advantage plans will send a personalized Mid-Year Enrollee Notification of Unused Supplemental Benefits to beneficiaries between June 30 and July 31.
This new requirement aims to help enrollees understand and utilize their unused supplemental benefits, such as dental, vision, and fitness perks. Each statement will include a detailed list of unused benefits, instructions on how to access them, and relevant support information.
We see this as a great opportunity to connect with clients midyear. By reviewing these statements with beneficiaries, you can ensure they’re maximizing their plan benefits while strengthening your relationship as a trusted advisor.
Learn more: How to Maximize the New Medicare Advantage Midyear Statement (2025)
The 2024 AEP for 2025 contracts brought new challenges:
With these shifts, agents play a pivotal role in helping clients navigate their options effectively.
For 2025, there are a few benefit changes:
Medicare continues to evolve, and it's important that we stay on top of those updates so we can educate our clients.
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