Medicare Part D Changes for 2025
September 3, 2024 | Kari Mellone
If you are enrolled in Medicare, you likely know that changes are a common occurrence. Because of this, staying informed is critical to understanding how you may be affected and being confident that the Medicare plan you are enrolled in is ideal for your needs.
This year is no exception – 2025 will bring significant changes to Medicare, specifically when it comes to Part D prescription medication coverage. In this blog, we’ll highlight what you need to know about the changes, how they could impact you and what actions you should take to ensure you have the right Medicare coverage.
Important Updates to Part D for Medicare Recipients
Major Part D changes started taking place in January 2023, when a new prescription drug law was enacted. The changes have resulted in significant savings in prescription medication costs for countless Medicare beneficiaries. The new law resulted in:
- Additional Vaccine Coverage: More vaccines are being fully covered by Medicare Part D.
- Medicare Negotiated Drug Prices: For the first time ever, ‘Medicare will be able to negotiate directly with manufacturers for the price of certain high-spending brand-name Medicare Part B and Part D drugs that don’t have competition.’
Source: https://www.medicare.gov/about-us/prescription-drug-law
Farewell to the Donut Hole
Starting January 1, 2025, Medicare recipients will experience the elimination of the coverage gap stage in their drug plans. This means that the dreaded “donut hole” in coverage will be a thing of the past.
Prescription Costs Will Be Capped
Additionally, for the first time in Medicare history, Part D medication costs will be capped at $2,000 out of your pocket annually. This significant change aims to make medications more affordable and accessible for everyone enrolled in Medicare, providing peace of mind and financial relief for those who need it most.
A Cost-Effective Solution
Another upcoming change is the introduction of the Medicare Prescription Payment Plan, or M3P. Those who have costly medications and choose to opt-in to Medicare’s prescription payment plan can even get their pricier medications at no upfront cost. Instead of paying the pharmacy, you can be billed through your insurance carrier. Moreover, the insurance company will send you a bill that caps your monthly payments. For instance, January’s statement would reflect $166.67 (or $2,000/12).
Each drug insurance carrier will be required to make these options available to you. However, your participation in the M3P program is voluntary.
If you are someone who uses generic medications or spends less than $100 a year on medications, switching to the payment plan is not advised. At Twin City Underwriters, we are closely overseeing the changes and how they will impact Medicare enrollees in 2025 to ensure we provide you with the latest updates and assistance in making Medicare coverage decisions. Contact us today with any questions you have.
Choosing a Medicare plan can be difficult. Twin City Underwriters helps Medicare recipients in Minnesota, Wisconsin, North Dakota, South Dakota, Iowa and Florida find the Medicare plan that meets their unique needs. Schedule a one-on-one meeting with one of our Medicare insurance brokers to get your questions answered!
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