The U.S. Department of Health and Human Services (HHS) and the Centers for Medicare & Medicaid Services (CMS) have issued the 2025 annual dollar limits on cost sharing. The maximum annual limitation on cost sharing that a group health plan can impose for 2025 is $9,200 for individual coverage and $18,400 for family coverage (compared with $9,450 and $18,900, respectively, for 2024) — a decrease of 2.6%.
Note: These limits are different from the IRS limits on health savings account (HSA)-qualified high-deductible health plans. The HSA cost sharing limits for 2025 will be released in spring 2024.[1]
As a reminder, under a new policy that begins in 2023, HHS will publish the premium adjustment percentage, maximum annual limitation on cost sharing, reduced maximum annual limitation on cost sharing and required contribution percentage by January of the year preceding the applicable benefit year (so by January 2024 for the 2025 benefit year). The guidance released by HHS and CMS reflects that new policy and sets forth the 2025 dollar limits.
CMS also issued the proposed Notice of Benefit and Payment Parameters for 2025 (including a fact sheet).
