Author Archives: Streamline Insurance Consultants LLC

When you are choosing a plan what are the things you are looking for? Total out-of-pocket cost, copays, ancillary benefits, customer service, network size, etc.? These are all things that the J.D Power Award looks at when deciding which plans are performing better than others. According to the J.D. Power 2024 “The top five drivers of satisfaction in the Medicare Advantage shopping experience are: preferred in-network doctors; adequate prescription drug coverage; preferred in-network hospitals and facilities; previous experience with a health plan; and existence of a copay.”

In 2025 the out-of-pocket max is going to be lowered to $2,000 for the whole year, but there is always still a concern about the upfront cost of medications, especially if you are going to be meeting that out-of-pocket max in the first month! Starting in 2025 Medicare is going to be introducing the  Medicare Prescription Payment Plan

The projections for 2025’s income-related monthly adjustment amount (IRMAA) are out. IRMAA is what decides your Medicare Part B premium. IRMAA is calculated on a sliding scale with five income brackets, with the bracket topping out at $500,000 for Single and $750,000 for Married/filing jointly. These figures will change annually to account for inflation. IRMAA calculations have a two-year look-back. So for plan year 2025, you will be looking at your gross adjusted income from your tax return in 2023 (two years ago).

The 2025 Medicare Part D Deductible will be increasing to $590.00 which is a $45.00 increase! This means that carriers can still elect to lower the deductible, but the Part D deductible cannot be higher than $590.00. Stand-alone Part D Plans may may offer higher monthly premiums in order to buy down the 2025 deductible.

In 2023, the federal government spent $832 billion on Medicare, which is 3.1% of the GDP. This makes Medicare the second largest program in the federal budget, after Social Security, and accounts for 21% of national health spending. As the population ages and healthcare costs increase, the Congressional Budget Office projects that Medicare spending will increase to 4.2% of GDP in 2034.

The Inflation Reduction Act signed into Law by President Biden will cause many changes in Medicare 2025 Plans. Plans will be mailing out a Notice of Changes in September for the 2025 plan year which will be effective January 1, 2025. Please make sure to read these changes carefully.