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For 2025, your Medicare options are essentially the same as in previous years, but there may be changes in premiums, coverage, and specific plans available in your area. Here’s a summary of your Medicare options for 2025:

At Atlantic Breeze Insurance LLC, we are licensed agents committed to providing unbiased information about Medicare plans. We work with leading insurers to offer a variety of Medicare Advantage, Medicare Supplement (Medigap), and Prescription Drug Plans that fit your healthcare needs and budget.
We follow CMS marketing guidelines to ensure that all information provided is accurate, non-misleading, and compliant with federal regulations.
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1. Original Medicare (Parts A and B)

Original Medicare includes:

Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home healthcare.
Part B (Medical Insurance): Covers outpatient care, doctor visits, preventive services, and some home healthcare.

Pros:

  • Flexibility to see any doctor or specialist that accepts Medicare.
  • No need for referrals or pre-approvals. Cons:
  • Does not cover prescription drugs, dental, vision, or hearing services.
  • You may have to pay coinsurance, copayments, and deductibles.
Doctor Meeting Teamwork Diagnosis Healthcare Concept
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1. Original Medicare (Parts A and B)

Original Medicare includes:

Part A (Hospital Insurance): Covers inpatient hospital stays, skilled nursing facility care, hospice care, and some home healthcare.
Part B (Medical Insurance): Covers outpatient care, doctor visits, preventive services, and some home healthcare.

Pros:

  • Flexibility to see any doctor or specialist that accepts Medicare.
  • No need for referrals or pre-approvals. Cons:
  • Does not cover prescription drugs, dental, vision, or hearing services.
  • You may have to pay coinsurance, copayments, and deductibles.
2. Medicare Advantage (Part C)

Medicare Advantage (Part C) plans are offered by private insurance companies and combine the benefits of Original Medicare (Part A and Part B) with additional coverage like prescription drugs, dental, vision, hearing, and sometimes wellness programs.

Types of Medicare Advantage Plans:

  • HMO (Health Maintenance Organization): Typically requires using network providers and getting referrals for specialists.
  • PPO (Preferred Provider Organization): Offers more flexibility to see out-of-network providers, though at a higher cost.
  • PFFS (Private Fee-for-Service): Offers flexibility in choosing healthcare providers but requires the provider to accept your plan’s terms.
  • SNP (Special Needs Plans): For individuals with specific health conditions (e.g., chronic illness, dual-eligible for Medicare and Medicaid).

Pros:

  • Includes prescription drug coverage (Part D) in many plans.
  • Additional benefits like dental, vision, and wellness programs.
  • May have lower premiums than Original Medicare.

Cons:

  • Must use plan’s network of doctors (for HMO/PPO plans).
  • Requires prior authorization for some services.
  • May have higher out-of-pocket costs than Original Medicare if you need to see out-of-network providers.
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2. Medicare Advantage (Part C)
Medicare Advantage plans are offered by Medicare-approved private insurance companies and include everything Original Medicare covers (Parts A & B), plus additional benefits like:
  • Prescription Drug Coverage (in many plans)
  • Dental, Vision, and Hearing Benefits
  • Wellness Programs and Fitness Memberships
Plans vary by location and provider. Contact us to compare available plans in your area.
Doctor, laptop and woman consulting in Telehealth, healthcare prescription or medicare diagnosis at
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Medicare Supplement (Medigap)
Medigap plans are offered by private companies to help pay for out-of-pocket costs not covered by Original Medicare (like copayments, coinsurance, and deductibles).

Pros:

  • Covers out-of-pocket expenses not covered by Original Medicare.
  • Provides flexibility to see any doctor or hospital that accepts Medicare.

Cons:

  • Does not cover prescription drugs (you’ll need a separate Part D plan for that).
  • Premiums tend to be higher than Medicare Advantage plans.
  • No coverage for additional benefits like dental or vision.
3. Medicare Supplement (Medigap)
Medicare Supplement plans help cover out-of-pocket costs such as:
  • Copayments
  • Coinsurance
  • Deductibles
Medigap plans are not Medicare Advantage plans. They work alongside Original Medicare and do not include prescription drug coverage.
4. Prescription Drug Coverage (Part D)
Part D provides prescription drug coverage, either through stand-alone plans (if you have Original Medicare) or included in Medicare Advantage plans.

Pros:

  • Helps cover prescription drug costs.
  • Some Part D plans offer coverage for a wide range of medications.

Cons:

  • You may face penalties if you don’t enroll when first eligible for Part D.
  • Costs and coverage may vary depending on the plan and your location.
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4. Medicare Prescription Drug Plans (Part D)
Medicare Part D helps cover the cost of prescription medications. Every plan has a formulary (list of covered drugs) that varies by provider.
Not all Part D plans cover the same medications, so it’s important to review your options.
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5. Special Needs Plans (SNPs)
SNPs are a type of Medicare Advantage plan designed for people with specific needs:
Dual-Eligible SNPs: For people who qualify for both Medicare and Medicaid.
Chronic Condition SNPs: For people with specific chronic conditions, such as diabetes or heart disease.
Institutional SNPs: For people living in nursing homes or other institutions.

Key Changes for 2025 (Expected)

While exact details of premiums and benefits are not always finalized yet, here are a few expected changes:
Premium and Deductible Adjustments: While exact details of premiums and benefits are not always finalized yet, here are a few expected changes
Expanded Telehealth Access: Medicare is expected to continue expanding telehealth services.
Prescription Drug Price Changes: The federal government has taken steps to negotiate prices for some prescription drugs, which may impact Part D costs.
Additional Benefits for Medicare Advantage Plans: Medicare Advantage plans might offer more benefits, such as meal delivery, transportation, Spending Grocery cards, OTC Cards and additional wellness services, where you can earn additional health dollars.
To Choose the Right Plan in 2025:

  • Assess your health needs

    Do you need prescription drug coverage? Do you have chronic conditions that might require additional care?

  • Compare plans

    Use the Medicare Plan Finder tool on the official Medicare website to compare plans available in your area based on premiums, benefits, and coverage.

  • Consider costs

    Think about monthly premiums, deductibles, copayments, and out-of-pocket maximums. Medicare Advantage plans may offer lower premiums but come with different out-of-pocket costs.

  • Look for additional benefits

    Some Medicare Advantage plans include dental, vision, hearing, and wellness programs. Check if these benefits are important to you.

  • Evaluate provider access

    If you want flexibility in choosing doctors, you may prefer a PPO or Medigap plan.

Healthcare Staff Conversing on Patient Care in Corridor
DISCLAIMER
Not connected with or endorsed by the U.S. government or the federal Medicare program.
We do not offer every plan available in your area. Currently, we represent 20 organizations offering 687 plans in your area. Please visit Medicare.gov or call 1-800-MEDICARE to get information on all your options.
By submitting your information, you agree to be contacted by a licensed insurance agent via phone, email, or text regarding Medicare plan options. This is a solicitation for insurance.
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