There are some changes to Medicare prescription drugs costs in 2025 that will affect those on Medicare plans. If you’re on a Medicare plan with changes in 2025, you may be receiving notifications from your plan. It’s important to contact your Medicare Agent, if you have one to review those changes.
Starting in 2025, all Medicare plans will include a $2,000 cap for out-of-pocket prescription drugs covered by your plan.
You’ll automatically get “catastrophic coverage, If your out-of-pocket spending on covered drugs reaches $2,000 (including certain payments made on your behalf, like through the Extra Help program). That means you won’t have to pay out-of-pocket for covered Part D drugs for the rest of the calendar year.
If you have a Medicare plan with drug coverage, compare plans during Medicare Open Enrollment to make sure your plan covers the drugs you take and meets your needs. Medicare Annual Enrollment Period is October 15 – December 7.
Medicare Part D will have several changes in 2025, including:
Out-of-pocket cap: The out-of-pocket limit for Part D drugs will be $2,000 per year, excluding premiums. This eliminates the coverage gap, also known as the “donut hole”.
Catastrophic coverage: Once the $2,000 limit is reached, you will enter catastrophic coverage and won’t pay anything more for prescription drugs that year.
Medicare Prescription Payment Plan (M3P): You can choose to spread out their prescription drug costs monthly instead of paying them all at once.
Deductibles: The average deductible for standalone Part D plans will be $466, with a maximum of $590. The average deductible for Medicare Advantage drug plans will be $306.
Low-income subsidies: Subsidies will be expanded to 150% of the federal poverty level (FPL).
Liability for catastrophic drug costs: Medicare’s liability for catastrophic drug costs will be reduced from 80% in 2024 to 20% for brands and 40% for generics in 2025.
Star ratings: Measure-level cut points will increase for 2025 Star Ratings.
These changes are part of the Inflation Reduction Act, which was signed into law in 2022.
Because of the prescription drug law, the coverage gap ends on December 31, 2024.
To find out about help with drug costs, you can visit Medicare.gov.
There are many changes that will take effect in 2025 that may affect you. You may be overwhelmed with different messages and advertising, especially during the Annual Enrollment Period.
One way to get your questions answers about available plans in your area is to work with a licensed Medicare agent that will help you.
You can find more information about the different prescription drug plans available in your area by working with a licensed Medicare Agent who is knowledgeable about plans and can help you compare all the different options.
You can Schedule a No-Cost Call with a licensed Medicare Agent from our office by clicking HERE.
You can also call us at 888-808-7646 or 213-816-0228 for faster service.
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