Medicare Part D: Important Changes Coming in 2025
June 24, 2024 | Tags:
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 Prescriptions
Beginning in 2025, the maximum out-of-pocket for Part D prescription drugs will be reduced form $8,000 to $2,000. Once this out-of-pocket 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 enrolled in Medicare Advantage or 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 annual limit for these payments is $2,000, which aligns with the out-of-pocket maximum.
“The Medicare Prescription Payment Plan is a budget-friendly option for members who want to avoid paying the full price for their pricier medications at checkout,” Goff said. “This program improves access to essential medications by easing the financial strain on members.”
Medicare Advantage members and 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 begone, 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.