Medicare will see several updates beginning in 2025 due to changes made by the Inflation Reduction Act in 2022.
The biggest change for recipients is a cap on drug costs for those with Medicare Part D at $2,000. If the costs of a Medicare Part D recipient’s drugs go over that cap, they won’t have coinsurance or copayments on any covered drugs for the rest of the calendar year. Recipients can also spread those drug costs over the year rather than paying up front, another new program in 2025.
Mental healthcare is also expanded for Medicare recipients, with outpatient programs, marriage and family therapists and mental health counselors now being covered in locations where those services are available. Additionally, as part of Medicare recipients’ yearly wellness visits, which are preventative visits to help develop personal health plans, they may receive a “social determinants of health risk assessment,” which is a questionnaire to help connect Medicare recipients with social services which may be beneficial for them. Medicare will also now cover training for caregivers in order to better prepare those helping medicare recipients by developing skills such as administering medications. Recipients would pay 20% of the cost of the training.
Telehealth coverage will be reduced beginning in 2025 for those not living in rural areas. Telehealth visits in non-rural areas will only now be covered for home dialysis, diagnosis, evaluation, or treatment of an acute stroke, treatment of substance use or mental health disorders, behavioral health services, diabetes self-management training, and medical nutrition therapy.
Enrollment information for Medicare can be found at ssa.gov/medicare/plan/when-to-sign-up.
Retirees and employees of the Postal Service will now have their own health program, the Postal Service Health Benefits Program. Current recipients of the Federal Employees Health Benefits program through the Postal Service will automatically be enrolled in the PSHBP, while new members will need to enroll in the window of November 11 through December 9, 2024.
