Medicare is undergoing some changes this year, and seniors and their caregivers should be aware of how their coverage may be affected. Some updates could make health care more affordable and accessible, while families may need to reconsider how they receive care as a result of others. 

Understanding these changes can help families plan ahead. Here’s what you need to know: 

New Drug Cost Caps, Payment Plans

Out-of-pocket prescription costs are now capped at $2,000. Those with Medicare Part D plans who reach the cap won’t be required to pay co-payments or co-insurance for drugs covered under Part D for the remainder of the year after the cap is reached. Medicare patients may now create payment plans for their prescriptions, paying a flat monthly installment to their health or drug plan provider instead of at the pharmacy.

Expanded Mental Health Care

New mental health care services, including intensive outpatient programs, marriage and family counseling and health risk assessments, have been added to Medicare’s coverage. Mental health counseling, including for behavioral health, occupational health and addiction recovery, is also available through Medicare. At annual Wellness visits, doctors can refer patients to support services based on their social needs.   

Caregiver Resources Available

New resources for caregivers may now be covered through Medicare. With a doctor’s approval, caregivers can become eligible for training through a patients’ treatment plan. Medicare also now covers inpatient respite care for those in hospice care, providing up to five days of rest for those caring for family members. Medicare has also introduced a new pilot program, called Guiding an Improved Dementia Experience Model, for those living with dementia with an unpaid caregiver; ask your doctor for more information.   

New Program for USPS

United States Postal Service employees, retirees and their families are now covered through the Postal Service Health Benefits program, instead of the Federal Employees Health Benefits program previously administered by their insurance. Those who are on both the PSHB program insurance and Medicare are likely to see cost savings, including Part B premium reimbursement and waived or reduced deductibles. 

In-office Telehealth Requirements

Since March 31, Medicare policy changes have required telehealth services to only be provided to those in rural areas obtaining the care at a medical facility. Some services, including end-stage renal disease visits, stroke care and mental or behavioral health care, are still available through telehealth.

Click here to get the full details on Medicare changes in 2025.