2025 Medicare Part D Changes 

If you’re eligible for Medicare, then having Medicare Part D has been an important aspect of your coverage and you should know about the changes taking place as a result of the Inflation Reduction Act from 2022. 

Here’s what changes are coming in 2025 and some tips for navigating the upcoming Annual Enrollment Period. 

2025 Changes Include:

New Part D design – With this new structure the “donut-hole” coverage gap is going away! You’ll pay 100% of your deductible. After you’ve met your deductible you’ll pay 25% of the cost of your drugs until you reach the out-of-pocket maximum. After that, you’ll pay nothing!

Lower Max Out of Pocket – The maximum out-of-pocket cost that you’ll pay for your prescriptions each year is now $2,000. 

Part D Manufacturer discount – Members with limited income who qualify for “Extra Help” will get an even bigger discount on their prescription drugs. You can talk to an agent about if you qualify for extra help. 

Prescription Drug Payment Plan – All Medicare prescription plans must offer a monthly payment plan. This is a program you can opt into at any time. It’s designed to help smooth out your prescription cost during the calendar year by spreading out the cost of more expensive prescriptions. 

What to expect when choosing a Part D Plan for 2025:

Starting in 2025, after you’ve paid your $2,000 deductible, insurance companies and drug manufacturers will pick up the majority of the tab. This could have an impact on your formulary and list of covered prescriptions. 

Other factors to consider:

Pharmacy Networks – The new payment plan could impact some consumers’ preferred pharmacies.

Plan Ratings & Reviews – Look carefully at The Star Ratings systems to compare which prescription drug plan may be right for you. An agent can help you understand the differences and see which coverage will be right for you, especially with next year’s changes. 

Evaluate the cost & coverage – When choosing the right plan, be sure to consider these factors: 

• Premiums 
• Annual deductibles
• Do you only take generics?

While Medicare coverage can seem overwhelming and the annual enrollment period can feel daunting, our agents are here to help. Consult with a Licensed Insurance Broker to get all your coverage questions answered. Schedule a free call today!