By Kate Ashford, NerdWallet

Each year, Medicare comes with a new set of prices, new plan ratings and sometimes new regulations. What you’ll pay may be different from last year, and your network and prescription drug coverage may change, depending on your plan. Here’s how Medicare looks in 2025.

Plan ratings have gone down

The average Medicare Advantage star rating in 2025 is 3.92 out of 5, weighted by enrollment, according to the Centers for Medicare & Medicaid Services. This is down from an average star rating of 4.07 in 2025 and represents the third year in a row that ratings have declined. Ratings also dropped for Medicare Part D plans, which have an average rating of 3.06 stars in 2025, weighted by enrollment. That’s down from an average of 3.34 stars in 2024.

Although there are slightly fewer Medicare Advantage plans offered in 2025, there are more plans that have lower star ratings. “Between 2022 and 2025, there was a 150-fold increase in the number of [Medicare Advantage] plans that had a 2 or 2.5 star rating out of 5,” says Diane Omdahl, president and co-founder of 65 Incorporated, which offers guidance on Medicare. “That’s huge.”

This means, Omdahl says, that Medicare Advantage plans receive less money in star bonuses from the federal government, which cuts into their bottom lines. “They look at ways to increase other things like prior authorizations and premiums,” Omdahl says. “It’s not good for the consumer.”

Some plans also chose to reduce benefits offerings in 2025, cutting back on extras like over-the-counter benefits and meal delivery. With fewer plans on the market, decreased perks and lower star ratings, it’s especially crucial that you compare plans in your area to find one that best fits your health care needs.

Part D out-of-pocket drug costs are capped

In 2025, Medicare Part D out-of-pocket costs for covered prescription drugs will be limited to $2,000. While this feels like a win for the consumer, there may be secondary effects. Because drug plans are required to pick up more of the cost of medications, many plans have stopped covering some drugs, Omdahl says.

“We did a survey and found that 50% of drug plans are not covering between five and eight of the most common nine insulins for diabetics,” Omdahl says. “Only one plan out of 14 covers an insulin called Basaglar. If that’s your insulin, and you have to change, that’s a big deal.”

The takeaway: Make sure your prescription drugs are still covered in 2025.

Note, too, that any purchases you make through online prescription drug discount sites — like GoodRx or Cost Plus Drugs — don’t count toward your out-of-pocket limit, says Gretchen Jacobson, vice president of Medicare for The Commonwealth Fund, a private foundation focused on promoting a high-performing health care system. “When we asked people on a survey if they’d ever used those sites, about 1 in 5 Medicare beneficiaries said that they had,” she says.

Some Medicare Advantage and Part D plans were dropped

It’s important to review your Medicare coverage before Medicare open enrollment ends on Dec. 7, because some providers merged or ended Medicare Advantage or Part D plans for 2025. If you haven’t read the Annual Notice of Change your insurer sent in September, give it a careful look.

“There is a tremendous change we’ve noticed in the availability of plans, and I don’t think it’s unique to California,” says Tatiana Fassieux, education and training specialist for California Health Advocates, a nonprofit offering Medicare advocacy and education. “In California in 2024, we had 26 [Part D] plans, and this coming 2025 there will only be 16 Part D plans.”

If your Medicare Advantage plan is ending, you can switch to another plan or return to Original Medicare; if you do nothing, you’ll be returned to Original Medicare by default. If your Part D plan is ending and you don’t choose another plan (and the provider doesn’t move you to one), you’ll be without prescription drug coverage in 2025.

Part A costs will go up

Medicare Part A covers inpatient care in hospitals and skilled nursing facilities, plus hospice care and some home health care. For most people, Medicare Part A is free because they’ve worked long enough to qualify for it. If you don’t qualify for premium-free Part A, you’ll pay up to $518 per month in 2025, compared to $505 per month in 2024.

The inpatient hospital deductible, which you pay before Medicare starts to cover costs, will be $1,676 in 2025 for each benefit period, compared to $1,632 in 2024. A benefit period ends if you haven’t received inpatient hospital care for 60 days in a row — so it’s possible to have more than one benefit period in a year (and owe more than one deductible).

If you have Medicare Supplement Insurance (Medigap), many plans cover some or all Part A costs.

Part B costs will go up

Medicare Part B covers medically necessary services such as doctor’s appointments and diagnostic tests, and preventive services such as vaccines and wellness visits.

Part B comes with a monthly premium of $185 per month in 2025, up from $174.70 in 2024. Part B also has a deductible, which you pay for care before Medicare starts covering costs. In 2025 the deductible will be $257, up from $240 in 2024.

If you have questions or need help, contact your State Health Insurance Assistance Program (SHIP), which offers free, unbiased counseling on Medicare. You can find your local SHIP by visiting shiphelp.org.

Kate Ashford, CSA® writes for NerdWallet. Email: kashford@nerdwallet.com. Twitter: @kateashford.

The article What’s New for Medicare in 2025? originally appeared on NerdWallet.