Confirmed Medicare price increase starting today – How it affects you

The open registration period for Medicare plans is open now, and the most important job seniors and those who qualify have to do now is to evaluate their coverage, check their options, and plan for their healthcare for next year.

This is quite important for Medicare beneficiaries specifically because of who they are. Those that are entitled to be a part of this federal health insurance program are Americans aged 65 and older, as well as younger individuals with disabilities or severe illnesses. These are some of the most vulnerable parts of the population and the ones who need the most help when it comes to healthcare, so weighing their options properly is the best thing they can do for their continued health.

The program was established in 1965 and has evolved to provide essential medical coverage to millions despite its challenges and oftentimes lack of support from politicians in charge of its funding, making its cost increase in an unsustainable way for those who can least afford for it to. It now has four key parts that can be used by beneficiaries:

• Part A helps cover inpatient care in hospitals, skilled nursing facility care, hospice care, and home health care.
• Part B helps cover services from doctors and other health care providers, outpatient care, home health care, durable medical equipment (like wheelchairs, walkers, hospital beds, and other equipment) and many preventive services (like screenings, shots or vaccines, and yearly “Wellness” visits).
• Part D helps cover the cost of prescription drugs (including many recommended shots or vaccines). You join a Medicare drug plan in addition to Original Medicare, or you get it by joining a Medicare Advantage Plan with drug coverage.
• Part C, better known as Medicare Advantage is an approved plan from a private company that offers an alternative to Original Medicare Part A and B for your health and drug coverage. These “bundled” plans include Part A, Part B, and usually Part D.

How Medicare Part D changes will affect insurers and beneficiaries

Part D has suffered some changes to prevent substantial premium hikes in 2025, like capping insured prescription drug costs at $2,000 annually, but these changes have made it difficult for the private sector to gauge the pricing of the service that they will be providing, and so, for the first time since 2006, the enrollment period has started without a clear list of prices for the Part D of Medicare.

But some seniors have an even bigger problem to contend with. Some insurance companies have decided that the changes in Medicare are too costly for them to bear and have decided to exit certain markets or significantly reduce their presence. This has left many beneficiaries without any options for Part C or D and only with the public options for Medicare coverage, which do not usually cover things like Dental or Vision.

This has made remaining insurers more prone to rise costs, not just to cover expenses, but because of the other lack of options in the market, which in turn has made the Centers for Medicare & Medicaid Services (CMS), the federal agency that runs the Medicare, Medicaid, and Children’s Health Insurance Programs, cap the increases at $35 per year.

This means that in 2025, the base premium for Part D will likely jump to $36.78, which is $2.08 more than in 2024—a rise of up to 6%. Even though this increase seems small, it can still put extra pressure on seniors and people with disabilities who often rely on fixed incomes. These changes could have a noticeable financial impact on Medicare recipients, but one of the ways the CMS is attempting to curve it is by covering a higher payment for each Part D enrollee.

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