Time to pick a 2025 Medicare plan! How to navigate the many changes.

Medicare annual enrollment is underway through Dec. 7, and millions of seniors may find picking a plan is much harder this year than in the past, experts said.
For the first time, out-of-pocket prescription drug costs will be capped annually at $2,000, and all enrollees will have the option to pay those costs in the form of capped monthly installment payments instead of all at once at the pharmacy. These are positives for consumers, particularly for those who reach the cap. AARP estimates that in 2025, 3.2 million Americans, or 8.4% of all those with a Part D drug plan, will reach the cap.
But to pay for the changes, insurers are tweaking their offerings, which could result in fewer benefits for many seniors that also could cost them more money, experts said.
Some insurers are cutting plans, exiting certain “unprofitable” markets, trimming popular offerings like dental coverage and increasing charges such as deductibles, premiums or co-payments that all Medicare enrollees pay.
“This year’s Medicare marketplace will be more chaotic than ever,” said Vijay Kotte, chief executive of Medicare marketplace GoHealth. “With fewer options, higher costs, and diminished benefits, older adults will be forced to navigate one of the most disruptive enrollment seasons in recent memory.”
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More than 80% of traditional Medicare users buy a Part D plan. Many also buy a supplemental plan, known as Medigap or Plan G, so that once the annual deductible is met, all out-of-pocket costs like co-insurance and co-payments are covered. Otherwise, Medicare doesn’t cover 20% of medical costs or prescriptions, and there’s no limit on out-of-pocket expenses.
Mary Johnson, 73, is one who must find a new drug plan. She’s enrolled this year in a popular Aetna Part D plan with a $5-a-month premium, and her three generic prescriptions are available before the deductible at zero co-pay, she said. That plan, which cost her about $64 for the year, will be discontinued in 2025.
“In 2025, my lowest-cost choice to replace that plan would result in increasing my premiums and out-of-pocket costs by $476, a total jump of 750%,” based on the same three generic drugs she’s now taking, Johnson said. Meanwhile, Social Security’s cost-of-living-adjustment for 2025 is 2.5%, she noted.
To save money, experts suggest:
“You can hold on to your money longer,” Whorley said. “If you’re a person who prefers to review bills at the end of the month and values predictability and certainty, then you’re interested in this.”
Cost is a top reason people ration their medications or don’t fill prescriptions, he said. Smaller, more predictable payments are easier to budget for and will encourage people to stick with medications, he said. All experts who spoke to USA TODAY said there’s no downside to choosing this option.
MA out-of-pocket costs are capped annually, but they’re high and will rise in 2025, America’s Health Insurance Plans said. The share of plans with maximum out-of-pocket-costs over $5,000 will rise to 52% in 2025 from 46% in 2024, the nonprofit group said. With a traditional Medicare policy with a Medigap plan, your annual out-of-pocket cost is the Part B deductible, which is $240 in 2024.
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Also, consider how much you travel and what your provider options are where you live. Traditional Medicare covers nearly all doctors and hospitals without referrals. Medicare Advantage covers in-network doctors and might require referrals and pre-authorizations for some care. “Medicare Advantage can be more cumbersome if you like to travel because you must stay in network,” Pruemm said.
Even if traditional Medicare plus Medigap costs more in monthly premiums, “Plan G is benefit-rich,” said Brandon Hill, senior adviser at Beckett Financial Group. “If the supplement fits in your budget, then get the supplement.”
Medora Lee is a money, markets, and personal finance reporter at USA TODAY. You can reach her at [email protected] and  subscribe to our free Daily Money newsletter for personal finance tips and business news every Monday through Friday morning.