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Important Plan and Coverage Changes for 2025

Posted Dec 30, 2024

As part of the Inflation Reduction Act, changes are being instituted to help make healthcare more affordable. These changes go into effect on January 1, 2025, and could affect many of your patients.

This page will be updated as more information becomes available.


 

Here's what you need to know.

News
Dual switching will be limited.

In the past, those on both Medicare and Medicaid (“Duals”) could switch Medicare Advantage plans every quarter. Beginning in 2025, patients on a dual plan will now be limited to how often they can switch outside of the Annual Enrollment Period and the Open Enrollment Period.

See this Provider Alert for more information.

News
Lower out-of-pocket costs for patients with Diabetes in a Qualified Health Plan or Essential Plan.

This will reduce costs (e.g., primary care office visits, prescription drugs, supplies, diagnostics) for those with a primary diagnosis of Diabetes, allowing for better management of their disease.

See this Provider Alert for more information. 

Additional Resources

Check out our Healthfirst Plans at a Glance. These resources offer relevant information to assist you in working with Healthfirst and our members.