Changes Coming To Medicare In 2025

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Changes coming to Medicare in 2025 could be beneficial for Oregon residents who are eligible for the program.

Oregonians who qualify for Medicare are now in the open enrollment period through Dec. 7, which allows them to search for health coverage plans to best suit their needs.

Ryan Kibby, Oregon Senior Health Insurance Benefits Assistance project director for the Oregon Department of Human Services, said there will be expanded care options for dementia patients with the Guiding and Improved Dementia Experience or GUIDE program.

“Some of the resources available through GUIDE would include a 24-hour support line, caregiver training and up to $2,500 a year for respite services,” Kibby outlined. “That’s really just going to help benefit the people who are providing these family caregiver services.”

There will also be expanded mental health benefits for people with Medicare in 2025. In 2023, nearly 920,000 Oregonians were enrolled in Medicare. People can get free help to find coverage through Oregon’s SHIBA program, either on its website or at 800-722-4134.

Kibby pointed out another major improvement in 2025 is prescription drug costs will be capped.

“There will be a lower maximum to pay for covered drugs, under both Medicare Part D policies and Medicare Advantage drug coverage,” Kibby explained. “The maximum amount that people will pay in 2025 is $2,000, and they won’t have to pay anything for covered drugs once they reach that amount.”

Prescription payment plans will be an option for people who cannot pay in full up-front. The out-of-pocket cost cap also eliminates a gap in coverage, known as the “donut hole,” which some have experienced in the past. While Medicare cannot cover prescriptions specifically for weight loss, people can access these drugs for treatment of conditions like Type 2 diabetes.
Oregon News Service

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