Changes are coming to Medicare Part D plans in 2025 that will lower drug costs and improve benefits. These changes are a result of the Inflation Reduction Act of 2022, which aims to make healthcare more accessible and affordable.
“Members with Original Medicare, Medicare Advantage or Medicare Supplement plans will pay significantly less out-of-pocket for their medications,” said Katie Goff, Director of Pharmacy-Medicare and Information Services at Medical Mutual.
Lower Out-of-Pocket Costs for Part D
Beginning in 2025, the maximum out-of-pocket for Part D prescription drugs will be reduced from $8,000 to $2,000. Once this maximum is reached, members enter the Catastrophic Phase.. At this stage, members pay nothing for their Part D drugs.
Budget-friendly Payment Options
Another new feature for 2025 is “smoothed” out-of-pocket costs through the Medicare Prescription Payment Plan. This program, which launches Jan. 1, 2025, allows individuals in a Medicare Part D plan the option to spread their out-of-pocket drug costs over the course of the year and pay in monthly installments. The maximum combined annual limit for these payments is $2,000, which aligns with the out-of-pocket maximum.
Members with Part D coverage can enroll in the Medicare Prescription Payment Plan for 2025 during Open Enrollment, which begins on Oct. 15. Medical Mutual will provide qualifying members with information on how to enroll in this program before it launches.
Elimination of the Coverage Gap Benefit Phase
The Coverage Gap Benefit Phase, also called the “donut hole,” put a temporary limit on the drug coverage provided by Medicare Part D plans.
In 2025, the Coverage Gap Benefit Phase will be gone, leaving the remaining phases: Annual Deductible, Initial Coverage, and Catastrophic. Medical Mutual is here to help you navigate these changes. Look for more information in the coming months about these changes.
Our knowledgeable Insurance Specialists offer a variety of free Medicare classes and workshops, throughout the year at SourcePoint and off-site locations. SourcePoint is a non-profit organization that provides unbiased information about Medicare so you can make informed decisions when choosing your coverage. All classes are free. No sales or promotions are involved. We do not represent or sell insurance products. For more information and to register for an upcoming workshop, please call 740-363-6677 or enroll here.