- What You’ll Pay for Medicare in 2025
- How to Talk to Your Doctors – and Get Them to Listen
- What Happens to Your Debt When You Die?
- Be Wary of Winter Heart Attacks
What You’ll Pay for Medicare in 2025
Dear Savvy Senior,
I know there will be a small 2.5 percent cost-of-living increase in Social Security benefits next year, but what about Medicare? What will the Medicare Part B monthly premiums be in 2025, and when do the surcharges kick in for higher income beneficiaries?
- Medicare Beneficiary
Dear Beneficiary,
The Centers for Medicare and Medicaid Services recently announced their cost adjustments for 2025 and the increases for premiums and out-of-pocket costs for most beneficiaries will be moderate. But if you’re a high earner, you’ll pay significantly more. Here’s what you can expect to pay in 2025.
Part B Premium
While Medicare Part A, which pays for hospital care, is premium-free for most beneficiaries, Part B, which covers doctor visits and outpatient services does have a monthly premium.
Starting in January, the standard monthly Part B premium will be $185, up from $174.70 in 2024. That $10.30 bump represents a 5.9 percent increase, which is more than double the most recent Social Security cost-of-living adjustment which was 2.5 percent.
But if you’re a high earning beneficiary, which makes up about 8 percent of all Medicare recipients, you’ll have to pay more. Medicare surcharges for high earners, known as the income-related monthly adjustment amount (or IRMAA), are based on adjusted gross income (AGI) from two years earlier, which means that your 2025 Part B premiums are determined by your 2023 AGI, which is on line 11 of the IRS tax form 1040.
Here’s how it breaks down. If your 2023 income was above $106,000 up to $133,000 ($212,000 up to $266,000 for married couples filing jointly), your 2025 Part B monthly premium will be $259.
Monthly Part B premiums for singles with an income between $133,000 and $167,000 ($266,000 and $334,000 for joint filers) will rise to $370.
Individuals earning above $167,000 up to $200,000 ($334,000 to $400,000 for joint filers) will see their monthly Part B premium increase to $480.90.
Those with incomes above $200,000 up to $500,000 ($400,000 to $750,000 for joint filers), will pay $591.90 per month in 2025. And single filers with income of $500,000 or more ($750,000 or more for joint filers) will pay $628.90 per month.
Part D Premium
If you have a stand-alone Medicare (Part D) prescription drug plan, the average premium in 2025 will be $46.50 per month for most beneficiaries, down from $53.95 in 2024. But again, for high earners with annual incomes above $106,000 ($212,000 for joint filers) you’ll pay a monthly surcharge of $13.70 to $85.80 (based on your income level) on top of your regular Part D premiums.
How to Contest Income
Beneficiaries that fall into any of the high-income categories and have experienced certain life-changing events that have reduced their income since 2023, such as retirement, divorce or the death of a spouse, can contest the surcharge. For more information on how to do this, see “Medicare Premiums: Rules for Higher-Income Beneficiaries” at SSA.gov/benefits/medicare/medicare-premiums.html.
Other Medicare Increases
In addition to the Part B and Part D premium increases, there are other cost increases you should be aware of. For example, the annual deductible for Medicare Part B will be $257 in 2025, which is $17 more than the 2024 deductible of $240. And the deductible for Medicare Part A, which covers hospital services, will increase to $1,676 in 2025. That’s $44 more than the 2024 deductible of $1,632. There are no surcharges on Medicare deductibles for high earners.
For more information on all the Medicare costs for 2025 visit Medicare.gov/basics/costs or call 800-633-4227.
How to Talk to Your Doctors – and Get Them to Listen
Dear Savvy Senior,
How can I get my doctors to listen better? I just turned 78, and over the past few years I feel more and more dismissed by my doctors. I know I can’t be the only one who feels this way. Any suggestions?
- Dissatisfied Patient
Dear Dissatisfied,
Communication difficulties between patients and their doctors is nothing new. Many older patients feel like their doctors are dismissing their concerns, which can be frustrating and lead to missed diagnoses and delayed care. If you believe your doctor isn’t listening to you, here are some tips offered by the National Institute on Aging that may help.
Prepare for your appointment: Before your exam, make a written prioritized list of any questions and concerns you want to discuss with your doctor, or print any online health research you’ve gathered, and bring it to your appointment so you won’t forget anything. If you’re in for a diagnostic visit, you should prepare a detailed description of your symptoms, when they began and what makes them worse.
Be honest and upfront: Even if the topic seems sensitive or embarrassing, it’s important to be honest and upfront with your doctor. You may feel uncomfortable talking about memory loss or bowel issues, but these are all important to your health. It’s better to be thorough and share detailed information than to be quiet or shy about what you’re thinking or feeling. Remember, your doctor is used to talking about all kinds of personal matters.
Ask specific questions: If you and your doctor aren’t communicating well, ask specific questions that require a response. For example: What might have caused the problem I’m dealing with? What’s the specific name of my diagnosis? Is the problem serious? Will it heal completely or require ongoing management? What future symptoms might suggest you need emergency care or a follow-up visit? When and how will you receive your test results? If you don’t understand something, don’t hesitate to ask: Can you explain that in simpler terms? Or: Can you give me more details about that?
Take someone with you: Bring along a family member or friend to your appointment. Your companion can help you ask questions or raise concerns that you hadn’t considered and listen to what the doctor is telling you and give you support.
Be persistent: If your doctor isn’t addressing your questions, repeat them or rephrase them. If you still don’t get anywhere, follow up with one of these statements: “I’m worried that we aren’t communicating well. Here’s why I feel that way.” Or: “I need to talk with you about X. I feel like I can’t. Can we talk about this?”
After your appointment, if you’re uncertain about any instructions or have other questions, call or email your health care provider. Don’t wait until your next visit to make sure you understand your diagnosis, treatment plan, or anything else that might affect your health.
For more tips, the National Institute on Aging offers a free booklet called “Talking with Your Doctor: A Guide for Older Adults” that can help you prepare for an appointment and become a better and more informed patient. To order free copy or see it online, visit order.nia.nih.gov/publication/talking-with-your-doctor-a-guide-for-older-adults.
Consider moving on: If you’re not making any progress with your doctor and the problem persists, it’s probably time to start looking for a new provider. Depending how unsatisfied you are with your care, you could also notify your doctor’s medical group and your insurance company or leave feedback on their online profile. If you’re dealing with a serious issue – like a doctor who prescribes the wrong medication or fails to provide test results in a timely manner – it might be appropriate to file a complaint with the state medical board.
What Happens to Your Debt When You Die?
Dear Savvy Senior,
Can my kids inherit my debt after I die? I have taken on a lot of credit card debt over the past 10 years or so, and I’m worried that my son and daughter will get stuck with it when I die.
- Indebted Senior
Dear Indebted,
In most cases when a person with debt dies, it’s their estate, not their kids, that is legally responsible. Here’s what you should know.
Debt After Death
When you die, your estate – which consists of the stuff you own while you’re alive (property, investments and cash) – will be responsible for paying your debts. If you don’t have enough cash to pay your debts, your kids will have to sell your assets and pay off your creditors with the proceeds.
Whatever is left over is passed along to your heirs as dictated by the terms of your will, if you have one. If you don’t have a will, the intestacy laws of the state you reside in will determine how your estate will be distributed.
If, however, you die broke, or there isn’t enough money left over to pay your “unsecured debts” – credit cards, medical bills, personal loans – then your estate is declared insolvent, and your creditors will have to eat the loss.
“Secured debts” – loans attached to an asset such as a house or a car – are a different story. If you have a mortgage or car loan when you die, those monthly payments will need to be made by your estate or heirs, or the lender can seize the property.
There are, however, a couple of exceptions that would make your kids legally responsible for your debt after you pass away. One is if your son and/or daughter is a joint holder on a credit card account that you owe on. And the other is if either one of them co-signed a loan with you.
Spouses Beware
If you’re married, these same debt inheritance rules apply to surviving spouses too, unless you live in a community property state, which includes Arizona, California, Idaho, Louisiana, Nevada, New Mexico, Texas, Washington and Wisconsin. In these states, any debts that one spouse acquires after the start of a marriage belongs to the other spouse too. Therefore, spouses in community property states are usually responsible for their deceased spouses’ debts.
Protected Assets
If you have any IRAs, 401(k)s, brokerage accounts, life insurance policies or employer-based pension plans, these are assets that creditors usually cannot get access to. That’s because these accounts typically have designated beneficiaries, and the money goes directly to those people without passing through the estate.
Settling the Estate
You should also make your kids aware that if you die with debt, and you have no assets, settling your estate will be fairly simple. Your executor will need to send out letters to your creditors explaining the situation, including a copy of your death certificate, and that will probably take care of it. But your kids may still have to deal with aggressive debt collectors who try to guilt them into paying.
If you have some assets, but not enough to pay all your debts, your state’s probate court has a distinct list of what bills get priority. The details vary by state, but generally estate administrating fees, funeral expenses, taxes and last illness medical bills get paid first, followed by secured debts and lastly, credit card debts.
Need Legal Help
If you or your kids have questions or need legal assistance, contact a consumer law attorney or probate attorney. If you can’t afford a lawyer, go to LawHelp.org to search for free legal help in your area.
Be Wary of Winter Heart Attacks
Dear Savvy Senior,
I’ve heard that people with heart problems need to be extra careful during the winter months because heart attacks are much more common. What can you tell me about this?
- AFib Alan
Dear Alan,
Everyone knows winter is cold and flu season, but many don’t know that it’s also the prime season for heart attacks too, especially if you already have a heart condition or have suffered a previous heart attack. Here’s what you should know, along with some tips to help you protect yourself.
In the U.S., the risk of having a heart attack during the winter months is twice as high as it is during the summertime. Why? There are a number of factors, and they’re not all linked to cold weather. Even people who live in warm climates have an increased risk. Here are the areas you need to pay extra attention to this winter.
Cold temperatures: When a person gets cold, the body responds by constricting the blood vessels to help the body maintain heat. This causes blood pressure to go up and makes the heart work harder. Cold temperatures can also increase levels of certain proteins that can thicken the blood and increase the risk for blood clots. So, stay warm this winter and when you do have to go outside, make sure you bundle up in layers with gloves and a hat, and place a scarf over your mouth and nose to warm up the air before you breathe it in.
Snow shoveling: Studies have shown that heart attack rates jump dramatically in the first few days after a major snowstorm, usually a result of snow shoveling. Shoveling snow is a very strenuous activity that raises blood pressure and stresses the heart. Combine those factors with cold temperatures and the risks for heart attack surges. If your sidewalk or driveway needs shoveling this winter, hire a kid from the neighborhood to do it for you, or use a snow blower. Or, if you must shovel, push rather than lift the snow as much as possible, stay warm, and take frequent breaks.
Every Jan. 1, millions of people join gyms or start exercise programs as part of their New Year’s resolution to get in shape, and many overexert themselves too soon. If you’re starting a new exercise program this winter, take the time to talk to your doctor about what types and how much exercise may be appropriate for you.
Winter weight gain: People tend to eat and drink more and gain more weight during the holiday season and winter months, all of which are hard on the heart and risky for someone with heart disease. So, keep a watchful eye on your diet this winter and avoid binging on fatty foods and alcohol.
Shorter days: Less daylight in the winter months can cause many people to develop “seasonal affective disorder” or SAD, a wintertime depression that can stress the heart. Studies have also looked at heart attack patients and found they usually have lower levels of vitamin D (which comes from sunlight) than people with healthy hearts. To boost your vitamin D this winter, consider taking a supplement that contains between 1,000 and 2,000 international units (IU) per day.
Flu season: Studies show that people who get flu shots have a lower heart attack risk. It’s known that the inflammatory reaction set off by a flu infection can increase blood clotting which can lead to heart attacks in vulnerable people. So, if you haven’t already done so this year, get a flu shot and Covid-19 booster for protection. And, if you’ve never been vaccinated for RSV or pneumococcal pneumonia, you should consider getting these vaccines too.
Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org. Jim Miller is a contributor to the NBC Today show and author of “The Savvy Senior” book.
