health-insurance – Restorative Pain Medicine Physicians

The 2025 Medicare costs that were released by CMS (Medicare) on Friday, November 8th, showed an increase in premiums and deductibles for both Medicare Parts A and B. Here’s a breakdown of the new costs that started Wednesday, January 1st:

Part A Costs (Inpatient Hospital)

The 2025 Part A inpatient hospital deductible rose by $44, from $1,632 in 2024 to $1,676 in 2025. This deductible resets every 60 days, potentially up to six times a year. For Skilled Nursing, the 2025 costs will be $0 copay per day for days 1-20, and $209.50 per day for days 21-100.

Part B Costs (Medical)

The 2025 Part B medical/doctor deductible increased by $17, from $240 in 2024 to $257 starting January 1, 2025. Once this deductible is met, Medicare covers 80% of the approved amount, and you pay the remaining 20%. Some of the Secondary plans do cover the deductible but many do not. Check with your Secondary provider to confirm.

Part B Premium

The premium increased by $10.30, from $174.70 in 2024 to $185.00 starting January 1, 2025. Higher-income individuals, earning over $106,000 individually or $212,000 as a couple, will pay more.

2025 Medicare Part D Costs and Co-pays

Initial Deductible

This has risen by $45, from $545 in 2024 to $590 on January 1, 2025.

Initial Coverage

There are five drug-tier stages. Your plan pays a share of drug costs and you pay yours until reaching a $2,000 out-of-pocket maximum, after which you enter the Catastrophic Coverage stage and pay $0.

Here’s a breakdown of the five drug tiers:

Generic Drugs – Lowest-cost. These drugs typically have the lowest copayments or coinsurance amounts.
Preferred Generic Drugs – These are generic drugs that your plan considers preferred. They might have even lower costs than standard generic drugs.
Preferred Brand Drugs – These are brand-name drugs that your plan considers preferred. They generally have higher copayments or coinsurance amounts than generic drugs but lower than non-preferred brand drugs.
Non-Preferred Drugs – These are brand-name drugs that your plan doesn’t consider preferred. They typically have the highest copayments or coinsurance amounts.
Specialty Drugs – These are high-cost medications used to treat complex conditions. They often have unique coverage rules and may require prior authorization.