Out-of-Pocket Drug Cost Cap: Beginning in 2025, Medicare Part D will implement a cap on annual out-of-pocket prescription drug costs at $2,000. Once this limit is reached, beneficiaries won't have to pay copayments or coinsurance for covered drugs for the rest of the year. ​Medicare

Medicare Prescription Payment Plan: Beginning in 2025, beneficiaries have the option to spread out-of-pocket prescription drug costs over the calendar year through the Medicare Prescription Payment Plan, aiding in budgeting for medication expenses. ​Medicare

Insulin Cost Cap: Starting in 2025, Medicare Part D will cap the monthly cost of insulin at $35 per covered prescription. This means beneficiaries will pay no more than $35 for a one-month supply of each Part D-covered insulin product, even if they obtain a three-month supply, which would cost no more than $105. ​Bricklayers Union+4Medicare+4Medicare+4

Increased Part B Premiums and Deductibles: For 2025, the standard monthly premium for Medicare Part B enrollees is set at $185.00, an increase from $174.70 in 2024. The annual deductible will be $257, up from $240 in the previous year. ​Centers for Medicare & Medicaid Services

Short-term health insurance provides temporary coverage, typically 1 to 12 months, and is ideal for those between jobs, waiting for other coverage, or outside of Open Enrollment.

Recent Changes:

Duration Limit: New regulations (effective September 1, 2024) limit short-term plans to 4 months, including renewals. Previously, these plans could last up to 12 months.
Source: HealthInsurance.org

State Regulations: Short-term plans are regulated differently in each state, so check your state's rules.
Source: HealthInsurance.org

Coverage Gaps: Short-term plans are not ACA-compliant, meaning they may not cover essential health benefits or pre-existing conditions.
Source: UHC

Things to Consider:

Short-term plans have limited coverage, and you could face higher out-of-pocket costs.

Compare options to ACA-compliant plans that offer more comprehensive coverage and may qualify for subsidies.

Expiration of Enhanced Subsidies: The enhanced federal health insurance subsidies introduced during the COVID-19 pandemic are set to expire at the end of 2025. This may lead to increased premiums for many consumers unless new measures are implemented. ​CT Insider+1KFF+1

Marketplace Integrity and Affordability Proposed Rule: The Centers for Medicare & Medicaid Services (CMS) has proposed eliminating fixed-dollar and gross percentage-based premium payment thresholds. This change aims to enhance program integrity by ensuring enrollees contribute to their premiums, reducing the risk of improper enrollments. ​Centers for Medicare & Medicaid Services+1Centers for Medicare & Medicaid Services+1

Simplified ACA Reporting: New legislation signed in December 2024, including the 'Paperwork Burden Reduction Act' and the 'Employer Reporting Improvement Act,' aims to streamline ACA reporting requirements, making the process easier and less time-consuming for employers. ​Smith Anderson