Medicare Announces 2025 Updates to Protect Seniors, Ensure Fair Competition Among Insurers

CMS announced 2025 updates to Medicare Advantage and Part D plans to enhance protections, ensure fair competition among plans, and better meet beneficiaries' needs.

New rules set guardrails on agent/broker compensation to curb anti-competitive steering practices in Medicare Advantage plan selection.

Regulations will restrict Third-Party Marketing Organizations from selling beneficiary data used for intrusive Medicare Advantage marketing strategies.

Network adequacy standards updated with new "Outpatient Behavioral Health" provider category to guarantee Medicare Advantage enrollee access to behavioral health services.

Medicare Advantage plans now required to notify enrollees mid-year about unused supplemental benefits that address social determinants of health needs.