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Now that is 2025, both Medicare beneficiaries and agents need to know what the Medicare premiums and deductibles 2025 are so that everyone can plan accordingly. 2025 is the same as previous years; CMS has made changes to both Medicare Part A & Part B premiums and deductibles.

Medicare Part A costs 2025

The majority of beneficiaries do not have to pay a Part A premium if they have worked for at least 40 quarters (10 years) and paid Medicare taxes. Although if they do not qualify for premium free Part A, there are a couple different premium amounts they can pay if they want Part A benefits.

When either the beneficiary or their spouse worked and paid Medicare taxes between 30 and 39 quarters, the monthly premium cost is $285 in 2025. This is an increase of $7 from the 2024 cost of $ 278.

If the beneficiary or their spouse worked at a job and paid Medicare taxes for less than 30 quarters, the premium in 2025 is $518. This an increase of $13 from the cost of $505 in 2024

Part A Deductible and Coinsurance 2025

Part A covers inpatient hospital costs. In 2025, the Part A deductible has gone up $1,676 for each benefit period. This is an increase of $44 from the cost of $1,632 in 2024.

On original Medicare once the beneficiary meets the deductible, the cost for a hospital stay is $0 for days 1-60. The cost for days 61-90 is $419 per day. This is $11 over the cost of $408 in 2024. Once the beneficiary reaches day 91 and over, they start to use their lifetime reserve days and pay $838 per day. that is up from $816 in 2024.

There is no coinsurance charge for days 1-20 in skilled nursing facility stays. The cost for days 21-100 are $209.50 per day in 2025. This is a $5.50 increase from the 2024 cost of $204.

Click here to learn about the Part D drug cap

Part B costs 2025

In contrast to the Part A premium, almost all beneficiaries have to pay a Part B premium. In special circumstances, if a beneficiary qualifies for extra help due to limited income and resources, they may not have to pay the Part B premium.

Part B Premiums & Deductibles

For 2025, the standard monthly premium has gone up $10.30 to $185.00. The premium was $174,70 in 2024.

Learn more about Part B costs

Those with an income level over a specified amount pay an IRMAA. The CMS adds the IRMAA to the standard monthly premium amount. The premium amount each beneficiary pays ranges from $259 to $628.90 per month if the beneficiary pays an IRMAA. The amount is based on their specific income level.

If you have been incorrectly charged an IRMAA, learn how to file an appeal.

The deductible amount for Part B in 2025 is $257, an increase of $17 from the 2024 cost of $240.

It is important for beneficiaries to stay updated on healthcare costs each year to manage their budgets and avoid surprises. CMS makes decisions on Medicare costs based on the projected rise in costs and use of healthcare.

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There are several ways to get more Medicare referrals. Medicare referrals are a fantastic, no cost way to grow your book of business. Once agents are established as a community resource may rely solely on referrals and do not have to spend money on other lead sources.

Build good relationships with your existing clients

Smart agents make sure they are available to answer any questions or concerns their clients have. This goes a long way to build client relationships. The most important thing you can do as an agent is to listen to your clients to understand their coverage needs and wants. Once they know you have their best interest at heart and provide good service, they are happy to recommend you to their friends and family.

It is important to stay in contact with your clients. This way they remember you are there for them and they do not ask another agent for assistance.

Contacting every client before AEP is another way that helps you stay in contact and also allows you to update their information before it is time to choose a plan for the coming year.

Sunfire and Connecture quoting and enrollment tools 2025 update

When a potential client contacts you be sure to Collect their contact information; email and phone to help you stay in contact if they give you permission to do so. This way agents can send out informational emails or contact a client if needed.  I some instances, agents can use phone numbers to contact clients via text message, if the prospect gives permission and you provide the option to opt out. Texts can be a quick and easy way to provide general information to a large number of clients at once.

Watch a YouTube video on AEP marketing rules

Online presence

A strong online presence is essential in today’s digital age. Agents should create a business profile on social media. Once you create the profile, it is imperative to update the platform with information potential clients may find helpful.  General information on Medicare choices and answers to common questions are good ways to engage readers and encourage repeat visits to your platform. An online presence has the capability of reaching a very large audience and presents you as knowledgeable resource in the field of Medicare.

Let Pinnacle help build your insurance website

Educational workshops

Hosting free Medicare workshops or webinars helps educate the community about coverage options and changes in Medicare. When you provide valuable information to those who need help, you gain credibility as a valuable resource.  Those who attend may refer friends or family to you for guidance when they need help with their Medicare options.

Learn the best practices for educational seminars, click here

Referral Incentives

Be sure to thank those who refer new clients to you with a small gift. Please note; incentives can include a gift card or anything appropriate with a value of not more than $15 that cannot be easily converted into cash. It is extremely important to be complaint when you offer a referral gift. Acknowledging and appreciating referrals encourages your existing clients to actively promote your business.

For referrals that you receive from other agents or professionals (ACA agents, P&C agents, other Medicare agents), referral gifts of up to $100 per sale is allowable. Remember to send the payment so they refer more clients to you.  Please note in most cases, financial planners cannot accept the referral gift.

If you have a client that is happy with the service you provide, you can ask them for referrals if you do it in a way that you are both comfortable with.

Collaborate with Local Businesses

Build relationships with local businesses that serve the senior population. Think about making connections with senior centers, fitness clubs, retirement communities or other local services. These relationships can be mutually beneficial, as you you can refer clients to one another.

Introduce yourself to local healthcare providers, clinics or care facilities. Once they know you and the service you provide, they may form a partnership with you. Having a good rapport with these providers opens doors to a new stream of leads.

Consider volunteering at local healthcare events and workshops to connect with providers and potential clients. Other professionals can refer people who need assistance with Medicare coverage. This also helps establish you as a reliable resource for Medicare coverage needs.

Join an FMO that will help you reach your full potential

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Stay up to date on Medicare plans and regulations

Agents need to stay educated on all available plan options as well as compliance rules. Be sure to attend product training sessions, workshops and conferences.  Broker managers and other agents are both sources of potential referrals if they have a beneficiary who needs assistance in your area.  A well informed and well-known agent is more likely to attract referrals from clients and other professionals.

A large referral network is a great way for MEdicare agents to achieve long-term success. Focusing on client satisfaction and following the suggestions above can help agents build a successful business that brings in new clients and more opportunities.

Many Medicare beneficiaries and agents have heard about the 2025 prescription payment. We will answer the question; what is the prescription payment plan. The plan is available to Medicare Part D beneficiaries. It provides a way to pay high out-of-pocket prescription costs by spreading them out over the course of months instead of all at once at the pharmacy. The prescription payment plan is sometimes called Smoothing. The payment plan is designed to make higher cost prescription drugs more affordable for Medicare beneficiaries.

How the program works

All Medicare Part D plan enrollees who have high cost prescriptions can participate in the prescription payment plan as long as the prescription is on their plan’s formulary. Plan enrollees can have their out of pocket prescription costs divided into manageable monthly payments over the course of the remaining months in the year.

Eligible beneficiaries simply contact their Part D insurance provider to opt into the program. The plan provider calculates the payments evenly over the course of the year. If the plan enrollee wants to add additional prescriptions to the payment plan, they contact their Part D insurance provider to have their payment arrangement adjusted. There is no charge to enroll in this program and beneficiaries do not pay interest or penalties.

Find out more about Part D costs for 2025

How to opt in to the prescription payment plan

It is not complicated to enroll in the plan. In some instances, Part D plan providers will contact beneficiaries who normally take high-cost prescriptions. Interested enrollees should contact the customer service number for their plan provider and request instructions to opt in.

Reasons to use the plan

There are many reasons to enroll in this program. For example; enrollment can provide a way for beneficiaries to manage their budget by spreading out the cost of their medication. This helps them avoid large pharmacy bills.

Knowing there is an alternative to a large bill, may help ensure beneficiaries fill their necessary prescriptions without financial stress. In some cases, beneficiaries may go without needed medications due to budget concerns. This can help eliminate that issue. The plan provides peace of mind with the safety of predictable monthly costs.

Learn about the $2,000 annual cap on Out-of-Pocket prescription costs

Watch a YouTube video on the drug cap for 2025

Because Medicare makes coverage changes each year, both agents and plan enrollees need to stay up to date on all information available. Knowing all the choices available helps beneficiaries receive needed coverage and plan for their year ahead. A licensed insurance agent can provide advice to ensure beneficiaries choose a plan that suite their needs and budget.

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